Individual provider Active NPI

Diana L Dillman, D.O.

  • Family Medicine Physician
  • Jenison, MI
National Provider Identifier
1235192188
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101013865 Issued in MI
Practice address
7686 Georgetown Center Dr
Jenison, MI 49428-8101
Phone
(616) 252-8600
Fax
(616) 252-8660
NPI assigned
Apr 11, 2006
Last updated
Dec 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101013865 MI Primary

Addresses

Primary practice location

7686 Georgetown Center Dr
Jenison, MI 49428-8101

Mailing address

5900 Byron Center Ave SW
Medical Administration
Wyoming, MI 49519-9606
Phone (616) 252-3243

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20050120000448 MI Practitioner - Family Practice 0143279752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

7686 Georgetown Ctr Dr
Jenison, MI 49428-8101
Phone (616) 252-8600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101013865MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital Family Medicine Current Accepting new patients
Metropolitan Hospital CurrentSince Jun 1, 2016 Accepting new patients
Metropolitan Hospital Past Accepting new patients

Locations

4200 Division Ave N
Comstock Park, MI 49321
Phone (616) 252-1600

7686 Georgetown Center Dr
Jenison, MI 49428
Phone (616) 252-8600

2215 44th St SW
Ste 100
Wyoming, MI 49519
Phone (616) 252-8300

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

5950 Metro Way SW
Wyoming, MI 49519
Phone (616) 252-8100

781 36th St SE
Wyoming, MI 49548
Phone (616) 252-4100

Interoperability endpoints

  • Direct secure messaging: ddillman590@direct.metrohealth.net

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1235192188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "address_2": "MEDICAL ADMINISTRATION",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-3243",
            "fax_number": "616-252-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7686 GEORGETOWN CENTER DR",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494288101",
            "telephone_number": "616-252-8600",
            "fax_number": "616-252-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLMAN",
        "first_name": "DIANA",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenison, MI

Sources for this page

Verify at the official NPI Registry.