Individual provider Active NPI

Shelly Dillon

  • Physical Therapist
  • Wilmington, NC
National Provider Identifier
1508189564
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P7500 Issued in NC
Practice address
3901 Wrightsville Ave Ste 120
Wilmington, NC 28403-6256
Phone
(910) 679-8385
NPI assigned
Mar 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X J10001481 DE
Physical Therapist 225100000X P7500 NC Primary

Addresses

Primary practice location

3901 Wrightsville Ave Ste 120
Wilmington, NC 28403-6256

Mailing address

3901 Wrightsville Ave Ste 120
Wilmington, NC 28403-6256
Phone (910) 679-8385

Other identifiers 1

IdentifierTypeStateIssuer
G00716OtherFACILITY MEDICARE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191219000336 NC Practitioner - Physical Therapist in Private Practice 5395906044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Brody School of Medicine at East Carolina University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
At Home Therapy Franchising LLCGroup PAC ID 8527489582, 17 clinicians

Practice addresses (Care Compare)

530 Causeway Dr
Suite B6
Wrightsville Beach, NC 28480-1954
Phone (910) 509-2810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P7500NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
At Home Therapy Franchising, LLC Physical Therapist CurrentSince Dec 11, 2025 Accepting new patients
At Home Therapy of Wilmington, Inc. Physical Therapist CurrentSince Dec 11, 2025 Accepting new patients
Ivyrehab North Carolina LLC PastSince Jan 19, 2020 Accepting new patients
Coastal Speech and Reading Center PastSince Nov 1, 2019 Accepting new patients

Locations

530 Causeway Dr
Ste B6
Wrightsville Beach, NC 28480
Phone (910) 509-2810

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1508189564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 WRIGHTSVILLE AVE STE 120",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036256",
            "telephone_number": "910-679-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 WRIGHTSVILLE AVE STE 120",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036256",
            "telephone_number": "910-679-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "SHELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-04",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J10001481",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P7500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY MEDICARE NUMBER",
            "identifier": "G00716",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.