Active NPI
Shayne Patrick Dillon, RPH
- Pharmacist
- Columbus, OH
National Provider Identifier
1245516665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03221524
- Practice address
- 4775 W Broad St
Columbus, OH 43228-1612 - Phone
- (614) 851-1126
- NPI assigned
- Oct 31, 2011
- Last updated
- Oct 31, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03221524 | OH | Primary |
Addresses
Primary practice location
4775 W Broad St
Columbus, OH 43228-1612
Mailing address
4775 W Broad St
Columbus, OH 43228-1612
Phone (614) 851-1126
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03221524 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320019200000",
"number": "1245516665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4775 W BROAD ST",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432281612",
"telephone_number": "614-851-1126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4775 W BROAD ST",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432281612",
"telephone_number": "614-851-1126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLON",
"first_name": "SHAYNE",
"middle_name": "PATRICK",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-31",
"last_updated": "2011-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03221524",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.