Individual provider Active NPI

Gary Duayne Dillon, DC

  • Chiropractor
  • Ashland, KY
National Provider Identifier
1013987163
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4584 Issued in KY
Practice address
5936 Swanson Dr
Ashland, KY 41102-7205
Phone
(606) 929-9667
Fax
(606) 929-9670
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4584 KY Primary

Addresses

Primary practice location

5936 Swanson Dr
Ashland, KY 41102-7205

Mailing address

5936 Swanson Dr
Ashland, KY 41102-7205
Phone (606) 929-9667

Other identifiers 6

IdentifierTypeStateIssuer
2556336MedicaidOH
85002335MedicaidKY
000000244994OtherKYBC BS ID #
3810002417MedicaidWV
0007160402OtherKYAETNA GROUP ID #
645626OtherKYACN GROUP #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110401000003 KY Practitioner - Chiropractic 7810924370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5936 Swanson Dr
Ashland, KY 41102-7239
Phone (606) 929-9667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4584KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dillon Chiropractic PLLC Chiropractor CurrentSince Nov 15, 2002 Accepting new patients
Physicians Imaging PSC PastSince Nov 15, 2002 Accepting new patients

Locations

5936 Swanson Dr
Ashland, KY 41102
Phone (606) 929-9667

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1013987163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5936 SWANSON DR",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411027205",
            "telephone_number": "606-929-9667",
            "fax_number": "606-929-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5936 SWANSON DR",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411027205",
            "telephone_number": "606-929-9667",
            "fax_number": "606-929-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "GARY",
        "middle_name": "DUAYNE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2556336",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85002335",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS ID #",
            "identifier": "000000244994",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810002417",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GROUP ID #",
            "identifier": "0007160402",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN GROUP #",
            "identifier": "645626",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.