Theresa Dillon, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

17470 Issued in WV

Practice address

738 Mercer St
Princeton, WV 24740-3114

Phone

(304) 323-3069

Fax

(304) 324-7946

NPI assigned

Jan 11, 2023

Last updated

Jan 11, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Princeton Community Homecare, LLC

  dba PCH Home Health

  • Home Health Agency
  • Princeton, WV
  • NPI 1861527715
  NPD
• Princeton Community Homecare, LLC

  dba PCH Home Health

  • Home Health Agency
  • Princeton, WV
  • NPI 1770971004
  NPD (past)

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

{
    "created_epoch": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1114631405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "738 MERCER ST",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247403114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 MERCER ST",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247403114",
            "telephone_number": "304-323-3069",
            "fax_number": "304-324-7946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "THERESA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WV",
            "license": "17470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "desktop/tablet",
            "affiliation": "N",
            "address_1": "738 Mercer St",
            "city": "Princeton",
            "state": "WV",
            "country_code": "US",
            "postal_code": "247403114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lindsey Devaughn, MSW
• Staccotta Dickerson
• Ashley Diffenbach
• Cody Blake Dillon, PTA
• Rory Dillon
• Jessica Dillow-Price, APRN, FNP-C
• Haley Morgan Dillow
• Katherine Dillow
• Misty Dillow, FNP
• Samantha Nicole Dillow

• Licensed Practical Nurse in Princeton, WV
• Providers in Princeton, WV by specialty
• Licensed Practical Nurse in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.