Active NPI
Charles M Dilla, P.T.
- Specialist
- Silver Spring, MD
National Provider Identifier
1528077443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 14012
- Practice address
- 11237 Lockwood Dr
Silver Spring, MD 20901-4554 - Phone
- (301) 681-6077
- Fax
- (301) 681-3798
- NPI assigned
- Aug 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 14012 | MD | Primary |
Addresses
Primary practice location
11237 Lockwood Dr
Silver Spring, MD 20901-4554
Mailing address
11237 Lockwood Dr
Silver Spring, MD 20901-4554
Phone (301) 681-6077
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 187040 | Other | MD | PHCS |
| 4555721 | Other | MD | AETNA PPO |
| 2425741 | Other | MD | AETNA HMO |
| F369-0001 | Other | DC | BCBS NCA |
| J201 | Other | MD | BCBS MD |
| 24348 | Other | MD | ALLIANCE/ MAMSI OC/ MDIPA |
| 983524 | Other | MD | IHP |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14012 | MD | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528077443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11237 LOCKWOOD DR",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209014554",
"telephone_number": "301-681-6077",
"fax_number": "301-681-3798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11237 LOCKWOOD DR",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209014554",
"telephone_number": "301-681-6077",
"fax_number": "301-681-3798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLA",
"first_name": "CHARLES",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MD",
"license": "14012",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "187040",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "4555721",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "2425741",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NCA",
"identifier": "F369-0001",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MD",
"identifier": "J201",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALLIANCE/ MAMSI OC/ MDIPA",
"identifier": "24348",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHP",
"identifier": "983524",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.