Individual provider Active NPI

Rosanna Dillard, FNP

  • Family Nurse Practitioner
  • Athens, OH
National Provider Identifier
1477052066
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN.380303 Issued in OH
Practice address
2131 E State St
Athens, OH 45701-2138
Phone
(740) 589-3100
Fax
(740) 589-3127
NPI assigned
Feb 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN.380303 OH Primary

Addresses

Primary practice location

2131 E State St
Athens, OH 45701-2138

Mailing address

553 Russell St
Middleport, OH 45760-1366

Other identifiers 1

IdentifierTypeStateIssuer
0273768MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rosanna.dillard.1@17389.direct.athenahealth.com

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180417001875 OH Practitioner - Nurse Practitioner 4880957240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holzer Clinic LLCGroup PAC ID 5890606008, 266 clinicians

Practice addresses (Care Compare)

2131 E State St
Athens, OH 45701-2138
Phone (740) 589-3100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN.380303OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
I Path LLC Current Accepting new patients
Holzer Clinic, LLC CurrentSince Apr 5, 2018 Accepting new patients

Locations

2131 E State St
Athens, OH 45701
Phone (740) 589-3100

5 N Court St
Ste 1
Athens, OH 45701
Phone (740) 589-7752

5 N Court St
Athens, OH 45701

90 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5131

100 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5050

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.

Hospital & facility affiliations 2

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": "1518048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1477052066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 RUSSELL ST",
            "city": "MIDDLEPORT",
            "state": "OH",
            "postal_code": "457601366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 E STATE ST",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457012138",
            "telephone_number": "740-589-3100",
            "fax_number": "740-589-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLARD",
        "first_name": "ROSANNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-08",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "RN.380303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0273768",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rosanna.dillard.1@17389.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "2131 E State St",
            "city": "Athens",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457012138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Athens, OH

Sources for this page

Verify at the official NPI Registry.