Individual provider Active NPI

Shawn Dillon

  • Athletic Trainer
  • Middle Island, NY
National Provider Identifier
1336004621
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
100 Longwood Rd
Middle Island, NY 11953-2000
Phone
(631) 345-9200
NPI assigned
Dec 18, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X NY Primary

Addresses

Primary practice location

100 Longwood Rd
Middle Island, NY 11953-2000

Mailing address

163 Flower Hill Dr
Shirley, NY 11967-1424
Phone (631) 345-9200

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

NPI Registry JSON

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

{
    "created_epoch": "1766016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1336004621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 FLOWER HILL DR",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119671424",
            "telephone_number": "631-345-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LONGWOOD RD",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532000",
            "telephone_number": "631-345-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "SHAWN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-18",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.