Individual provider Active NPI

Craig L. Dillman, D.C.

  • Orthopedic Chiropractor
  • San Diego, CA
National Provider Identifier
1104845122
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
DC14004 Issued in CA
Practice address
4241 Jutland Dr
Ste 202
San Diego, CA 92117-3661
Phone
(619) 275-0922
Fax
(619) 275-0945
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X DC14004 CA Primary

Addresses

Primary practice location

4241 Jutland Dr
Ste 202
San Diego, CA 92117-3661

Mailing address

4241 Jutland Dr
Ste 202
San Diego, CA 92117-3661
Phone (619) 275-0922

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090223000256 CA Practitioner - Chiropractic 5991860140 Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4241 Jutland Dr
Suite 202
San Diego, CA 92117-3661
Phone (619) 275-0922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC14004CAMDOrthopedic Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Jerry Rand Apmc Past Accepting new patients

Organizations & group practices 1

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1104845122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4241 JUTLAND DR",
            "address_2": "STE 202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921173661",
            "telephone_number": "619-275-0922",
            "fax_number": "619-275-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4241 JUTLAND DR",
            "address_2": "STE 202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921173661",
            "telephone_number": "619-275-0922",
            "fax_number": "619-275-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLMAN",
        "first_name": "CRAIG",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "CA",
            "license": "DC14004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.