Mary Linda Dillard, ARNP

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

3004742 Issued in KY

Practice address

1102 S Virginia St
Hopkinsville, KY 42240-3579

Phone

(270) 632-6741

Fax

(270) 632-6742

NPI assigned

Jun 15, 2006

Last updated

Oct 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Mary Linda Owen Former name

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pennyroyal Healthcare Services, IncGroup PAC ID 6002076700, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jennie Stuart Medical Center Hospital, Hopkinsville, KY, CCN 180051

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Pennyroyal Healthcare Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hopkinsville, KY
  • NPI 1124319942
  Medicare reassignment Care Compare group NPD
• Pennyroyal Healthcare Services, Inc

  dba Community Dental

  • Federally Qualified Health Center (FQHC)
  • Hopkinsville, KY
  • NPI 1104532332
  NPD
• Commonwealth of Kentucky

  dba Western State Hospital

  • Psychiatric Hospital
  • Hopkinsville, KY
  • NPI 1508861683
  NPD (past)

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

• Jennie Stuart Medical Center Inc

  • General Acute Care Hospital
  • Hopkinsville, KY
  • NPI 1235139312
  Care Compare affiliation

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1306880034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 S VIRGINIA ST",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422403579",
            "telephone_number": "270-632-6741",
            "fax_number": "270-632-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 S VIRGINIA ST",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422403579",
            "telephone_number": "270-632-6741",
            "fax_number": "270-632-6742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLARD",
        "first_name": "MARY",
        "middle_name": "LINDA",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3004742",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "KY",
            "license": "3004742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "OWEN",
            "middle_name": "LINDA",
            "prefix": "MS.",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jaimie Nicole Devine, RN
• Madalyn Grace Dewey
• Tracey Diane Dexter-Eaves, O.D.
• Kathy Dickinson
• Mack Dillard Jr.
• Toya Lynette Dillard
• Melissa Divack
• Gary Dixon, CADC
• Howard Dixon, CADC
• Kara Harton Dixon, PA

• Adult Health Clinical Nurse Specialist in Hopkinsville, KY
• Providers in Hopkinsville, KY by specialty
• Adult Health Clinical Nurse Specialist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.