Individual provider Active NPI

Andrea Ruth Dillon, MD

  • Family Medicine Physician
  • Englewood, OH
National Provider Identifier
1316207889
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.125354 Issued in OH
Practice address
200 Rockridge Rd Ste 100
Englewood, OH 45322-2748
Phone
(937) 274-2117
Fax
(937) 274-9809
NPI assigned
May 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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 35.125354 OH Primary

Addresses

Primary practice location

200 Rockridge Rd Ste 100
Englewood, OH 45322-2748

Mailing address

200 Rockridge Rd Ste 100
Englewood, OH 45322-2748
Phone (937) 274-2117

Other identifiers 1

IdentifierTypeStateIssuer
35.125354OtherOHMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150622002546 OH Practitioner - Family Practice 0143457820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Integrated Medical Assoc LTDGroup PAC ID 9032101399, 21 clinicians

Practice addresses (Care Compare)

200 Rockridge Rd
Suite 100
Englewood, OH 45322-2748
Phone (937) 274-2117

Hospital & facility affiliations

  • Fidelity Health Care Home health agency, Moraine, OH, CCN 367160
  • Kettering Homecare Home health agency, Kettering, OH, CCN 367778
  • Ohioans Home Healthcare, Inc Home health agency, Vandalia, OH, CCN 368379
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
  • Upper Valley Medical Center Hospital, Troy, OH, CCN 360174
  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Integrated Medical Assoc LTD Family Medicine CurrentSince Aug 3, 2015 Accepting new patients
Premier Integrated Medical Assoc LTD Family Medicine CurrentSince Aug 3, 2015 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

25 Merchant St
Ste 220
Cincinnati, OH 45246

7211 N Main St
Ste 1
Englewood, OH 45415
Phone (937) 274-2117

200 Rockridge Rd
Ste 100
Englewood, OH 45322
Phone (937) 274-2117

3080 Ackerman Blvd
Ste 220
Kettering, OH 45429
Phone (937) 294-3228

1900 Composite Dr
Kettering, OH 45420
Phone (937) 293-8419

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1316207889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ROCKRIDGE RD STE 100",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453222748",
            "telephone_number": "937-274-2117",
            "fax_number": "937-274-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ROCKRIDGE RD STE 100",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453222748",
            "telephone_number": "937-274-2117",
            "fax_number": "937-274-9809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "ANDREA",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-18",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.125354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "35.125354",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, OH

Sources for this page

Verify at the official NPI Registry.