Individual provider Active NPI

Ronald Boe Dillman, LMSW-P

  • Clinical Social Worker
  • Shawnee, OK
National Provider Identifier
1457158339
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
21156-P Issued in OK
Practice address
326 W 11TH St
Shawnee, OK 74801-6710
Phone
(405) 432-3480
NPI assigned
Feb 27, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 21156-P OK Primary

Addresses

Primary practice location

326 W 11TH St
Shawnee, OK 74801-6710

Mailing address

326 W 11TH St
Shawnee, OK 74801-6710
Phone (405) 432-3480

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

State licenses

LicenseStateTypeSpecialty
21156-POKMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1457158339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 W 11TH ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748016710",
            "telephone_number": "405-432-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 W 11TH ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748016710",
            "telephone_number": "405-432-3480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLMAN",
        "first_name": "RONALD",
        "middle_name": "BOE",
        "credential": "LMSW-P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "21156-P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.