Active NPI
Jane Ellen Dill, M.D.
- Family Medicine Physician
- Flagstaff, AZ
National Provider Identifier
1154413763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 28143
- Practice address
- 2920 N 4TH St
Flagstaff, AZ 86004-1816 - Phone
- (928) 213-6100
- Fax
- (928) 774-4808
- NPI assigned
- Sep 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 28143 | AZ | Primary |
Addresses
Primary practice location
2920 N 4TH St
Flagstaff, AZ 86004-1816
Mailing address
PO Box 3630
Flagstaff, AZ 86003-3630
Phone (928) 233-5110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040407001292 | AZ | Practitioner - Family Practice | 7517950140 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Country Healthcare, Inc. | Current | Accepting new patients | |
| North Country Healthcare, Inc. | Current | Accepting new patients | |
| North Country Healthcare, Inc. | Family Medicine | Current | Accepting new patients |
| North Country Healthcare, Inc. | Current | Accepting new patients |
Locations
2920 N 4th St
Flagstaff, AZ 86004
Phone (928) 213-6100
2500 N Rose St
Flagstaff, AZ 86004
Phone (928) 213-6121
301 S 7th St
Williams, AZ 86046
Phone (928) 380-2611
620 Lee St
Winslow, AZ 86047
Phone (928) 288-8700
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Lake Havasu City, AZ
- NPI 1033359468
-
- Multi-Specialty Clinic/Center
- Flagstaff, AZ
- NPI 1073583472
-
- Multi-Specialty Clinic/Center
- Show Low, AZ
- NPI 1073740098
-
- Family Medicine Physician
- Flagstaff, AZ
- NPI 1619345675
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303776000000",
"number": "1154413763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3630",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860033630",
"telephone_number": "928-233-5110",
"fax_number": "928-774-6687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2920 N 4TH ST",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860041816",
"telephone_number": "928-213-6100",
"fax_number": "928-774-4808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILL",
"first_name": "JANE",
"middle_name": "ELLEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-29",
"last_updated": "2011-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "28143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.