Active NPI
Russell King Dillon, PT
- Physical Therapist
- Grants Pass, OR
National Provider Identifier
1164711156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2641
- Practice address
- 7315 N Applegate Rd
Grants Pass, OR 97527-9443 - Phone
- (541) 862-2189
- NPI assigned
- Mar 31, 2011
- Last updated
- Mar 31, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2641 | OR | Primary |
| Physical Therapist | 225100000X | 10234 | CA |
Addresses
Primary practice location
7315 N Applegate Rd
Grants Pass, OR 97527-9443
Mailing address
7315 N Applegate Rd
Grants Pass, OR 97527-9443
Phone (541) 862-2189
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2641 | OR | MD | Clinical Social Worker |
| 10234 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301529600000",
"number": "1164711156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7315 N APPLEGATE RD",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975279443",
"telephone_number": "541-862-2189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7315 N APPLEGATE RD",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975279443",
"telephone_number": "541-862-2189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLON",
"first_name": "RUSSELL",
"middle_name": "KING",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-03-31",
"last_updated": "2011-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "2641",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "10234",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grants Pass, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.