Individual provider Active NPI

Nandi R Dillard, LCSW

  • Clinical Social Worker
  • Plantation, FL
National Provider Identifier
1538846142
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW21729 Issued in FL
Practice address
6738 W Sunrise Blvd
Plantation, FL 33313-6070
Phone
(954) 874-8010
NPI assigned
Jul 5, 2023
Last updated
Jul 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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 SW21729 FL Primary

Addresses

Primary practice location

6738 W Sunrise Blvd
Plantation, FL 33313-6070

Mailing address

17520 NW 10TH CT
Miami Gardens, FL 33169-4602
Phone (954) 520-5492

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240622000532 FL Practitioner - Clinical Social Worker 9335682020 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Luis Hines & Associates, PA CurrentSince Apr 17, 2024 Accepting new patients
O Yes Medical Services Inc. PastSince Apr 17, 2024 Accepting new patients
Shine Medical Providers PC Past Accepting new patients

Locations

2828 Coral Way
Ste 460
Miami, FL 33145
Phone (305) 642-5255

12550 Biscayne Blvd
Ste 306
North Miami, FL 33181
Phone (305) 895-0504

Organizations & group practices 3

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": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1538846142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17520 NW 10TH CT",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331694602",
            "telephone_number": "954-520-5492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6738 W SUNRISE BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333136070",
            "telephone_number": "954-874-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLARD",
        "first_name": "NANDI",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW21729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.