Jennifer Allyn Dillaha, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

E-1249 Issued in AR

Practice address

4815 W Markham St
Slot 41
Little Rock, AR 72205-3866

Phone

(501) 280-4055

Fax

(501) 661-2055

NPI assigned

Jul 12, 2007

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

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Arkansas Department of Health Payroll Office

  • Public Health or Welfare Agency
  • Little Rock, AR
  • NPI 1619195906
  Medicare reassignment
• State of Arkansas

  • Skilled Nursing Facility
  • North Little Rock, AR
  • NPI 1689117756
  NPD (past)
• State of Arkansas

  dba Lonoke County Health Unit

  • Home Health Agency
  • Lonoke, AR
  • NPI 1932119070
  NPD (past)

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1174722904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 W MARKHAM ST",
            "address_2": "SLOT 41",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053866",
            "telephone_number": "501-280-4055",
            "fax_number": "501-661-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 W MARKHAM ST",
            "address_2": "SLOT 41",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053866",
            "telephone_number": "501-280-4055",
            "fax_number": "501-661-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLAHA",
        "first_name": "JENNIFER",
        "middle_name": "ALLYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-1249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dale Dildy, MD
• Phillip Michael Dileo
• D'Ann Diles, M.ED, ECSE
• Timothy R Diles, M.D.
• Abby Dilick
• Audrey Dillahunty, CRNA
• Daniel Dillard, MD
• India Dillard
• Dillard's, Inc.
• Emma Kathryn Dilley

• Internal Medicine Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Internal Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.

Verify at the official NPI Registry.