Individual provider Active NPI

James Daniel Dillon Jr., MD

  • Neurological Surgery Physician
  • Aiken, SC
National Provider Identifier
1285736702
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
32617 Issued in SC
Practice address
410 University Pkwy Ste 1520
Aiken, SC 29801-6840
Phone
(803) 502-8400
Fax
(803) 641-7015
NPI assigned
Sep 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 632617 SC
Neurological Surgery Physician 207T00000X 32617 SC Primary

Addresses

Primary practice location

410 University Pkwy Ste 1520
Aiken, SC 29801-6840

Mailing address

367 S Gulph Rd
Attn Ipm Credentialing
King of Prussia, PA 19406-3121
Phone (803) 502-9400

Other identifiers 2

IdentifierTypeStateIssuer
10372771MedicaidVA
326178MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20110308000141 SC Practitioner - Neurosurgery 2860398013 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
632617SCMDSpecialist
32617SCMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aiken Regional Medical Centers LLC Current Accepting new patients

Locations

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

137 Miracle Dr
Aiken, SC 29801
Phone (803) 226-0589

100 Aurora Pl
Ste 300
Aiken, SC 29801
Phone (803) 226-0130

410 University Pkwy
Ste 1520
Aiken, SC 29801
Phone (803) 502-8400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1285736702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S GULPH RD",
            "address_2": "ATTN IPM CREDENTIALING",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "803-502-9400",
            "fax_number": "803-641-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 UNIVERSITY PKWY STE 1520",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016840",
            "telephone_number": "803-502-8400",
            "fax_number": "803-641-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "JAMES",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-04",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "632617",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "SC",
            "license": "32617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10372771",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "326178",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.