Active NPI
Kimberly L. Dillon, M.D.
- Pediatrics Physician
- Bryan, OH
National Provider Identifier
1376599043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 35080816
- Practice address
- 442 W High St Ste 3
Bryan, OH 43506-1681 - Phone
- (419) 636-4517
- Fax
- (419) 636-6438
- NPI assigned
- May 25, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Bryan, OH
- NPI 1962458521
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050321001003 | OH | Practitioner - Pediatric Medicine | 2961467725 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35080816 | OH | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Hospitals and Wellness Centers | Past | Accepting new patients |
Interoperability endpoints
- kdillon6690@direct.parkviewexchange.com
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35080816 | OH | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
442 W High St Ste 3
Bryan, OH 43506-1681
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2345993 | Medicaid | OH |
Other names 1
NPPES NPI Registry- Kimberly L. Fink
Electronic endpoints 3
NPPES NPI Registry| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kdillon6690@Direct.Parkviewexchange.com | ||
| FHIR URL | https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/ | ||
| FHIR URL | https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/ |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 12, 2022.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670803200000",
"number": "1376599043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11109 PARKVIEW PLAZA DR # 117",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "442 W HIGH ST STE 3",
"city": "BRYAN",
"state": "OH",
"postal_code": "435061681",
"telephone_number": "419-636-4517",
"fax_number": "419-636-6438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLON",
"first_name": "KIMBERLY",
"middle_name": "L.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-25",
"last_updated": "2022-12-12",
"certification_date": "2022-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "35080816",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2345993",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kdillon6690@Direct.Parkviewexchange.com",
"affiliation": "N",
"address_1": "442 W High St",
"city": "Bryan",
"state": "OH",
"country_code": "US",
"postal_code": "435061681",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "442 W High St",
"city": "Bryan",
"state": "OH",
"country_code": "US",
"postal_code": "435061681",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
"affiliation": "N",
"address_1": "442 W High St",
"city": "Bryan",
"state": "OH",
"country_code": "US",
"postal_code": "435061681",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "KIMBERLY",
"last_name": "FINK",
"middle_name": "L.",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Bryan, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.