Dillon Small, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY.0005552 Issued in CO

Practice address

2348 Sijan Dr Ste 2A13
Usaf Academy, CO 80840-8203

Phone

(317) 362-4878

NPI assigned

Sep 6, 2012

Last updated

Mar 24, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindsight Health

  dba Mindsight

  • Clinical Psychologist
  • Colorado Springs, CO
  • NPI 1730853672
  NPD Authorized official

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1477802320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 SOUTH SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "90230",
            "telephone_number": "310-390-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2348 SIJAN DR STE 2A13",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808408203",
            "telephone_number": "317-362-4878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4760 South Sepulveda Blvd",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "90230",
            "country_code": "US",
            "telephone_number": "310-390-6612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5546 Old River Dr",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809248127",
            "country_code": "US",
            "telephone_number": "402-730-8234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMALL",
        "first_name": "DILLON",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-06",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20043068A",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY..0005552",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0005552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dillon.small@usafa.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "2348 Sijan Dr Ste 2A13",
            "city": "Usaf Academy",
            "state": "CO",
            "country_code": "US",
            "postal_code": "808408203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stacy Ann Shackelford, M.D.
• Christopher D Shawver, DNP, CRNA
• Mark D Sheehan, M.D.
• Justine Roberta Lee Sherman, NP
• Hector C Siordia Jr., D.D.S.
• Joshua M Smalley, D.O
• Lisa Alma Smith
• Jenny Patterson Spahr, RN, PNP
• Angela Christine Spangler, PSY.D.
• Scott Andrew Sprenger, PHARM.D.

• Clinical Psychologist in Usaf Academy, CO
• Providers in Usaf Academy, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.