Individual provider Active NPI

Shena Dillon, M.D.

  • Obstetrics & Gynecology Physician
  • Fort Worth, TX
National Provider Identifier
1548585607
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
P9836 Issued in TX
Practice address
1400 8TH Ave
Fort Worth, TX 76104-4110
Phone
(817) 922-4532
Fax
(817) 922-4553
NPI assigned
Apr 1, 2010
Last updated
Oct 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X P9836 TX Primary

Addresses

Primary practice location

1400 8TH Ave
Fort Worth, TX 76104-4110

Mailing address

1400 8TH Ave
Fort Worth, TX 76104-4110
Phone (817) 922-4532

Other identifiers 1

IdentifierTypeStateIssuer
341682801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140827002662 TX Practitioner - Obstetrics/Gynecology 6800014168 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Texas Southwestern Medical School at Dallas, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatrix Medical Group of Texas Billing IncGroup PAC ID 0042283921, 36 clinicians

Practice addresses (Care Compare)

1400 8TH Ave
Fort Worth, TX 76104-4110
Phone 80024338397746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Dec 1, 2015 Accepting new patients
Pediatrix Medical Group of Texas Billing, Inc. Obstetrics & Gynecology CurrentSince Sep 17, 2021 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Obstetrics & Gynecology CurrentSince Dec 1, 2015 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Compassion Health Services LLC Past Accepting new patients
Baylor All Saints Medical Center Past Accepting new patients

Locations

800 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 548-6100

1201 W 38th St
Austin, TX 78705
Phone (512) 324-1058

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

3500 Gaston Ave
Dallas, TX 75246

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 6

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": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1548585607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044110",
            "telephone_number": "817-922-4532",
            "fax_number": "817-922-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044110",
            "telephone_number": "817-922-4532",
            "fax_number": "817-922-4553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "SHENA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-01",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "P9836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341682801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.