NPIMap

Individual provider Active NPI

Dillon Pender, MD

  • Family Medicine Physician
  • Glasgow, KY
National Provider Identifier
1639666571
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
55213 Issued in KY
Practice address
310 N L Rogers Wells Blvd
Glasgow, KY 42141-1300
Phone
(270) 659-5555
NPI assigned
Apr 17, 2018
Last updated
Mar 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X R4843 KY
Family Medicine Physician 207Q00000X 55213 KY Primary

Addresses

Primary practice location

310 N L Rogers Wells Blvd
Glasgow, KY 42141-1300

Mailing address

170 Winter Park PL
Elizabethtown, KY 42701-8396

Other practice location 1

1325 N Race St
Glasgow, KY 42141-3427
Phone (270) 651-4865

Other identifiers 2

IdentifierTypeStateIssuer
7100603490MedicaidKY
K300041OtherKYMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200430002744 KY Practitioner - Emergency Medicine 7810224326 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Louisville School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians
Urgent Care Services Southeast PSCGroup PAC ID 0345694766, 18 clinicians

Practice addresses (Care Compare)

1301 N Race St
Glasgow, KY 42141-3454
Phone (270) 651-4471

310 N L Rogers Wells Blvd
Glasgow, KY 42141-1300
Phone (270) 651-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score
86.3 of 100Reported as group
Quality
74.59
Promoting interoperability
100
Improvement activities
40
Cost
68.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R4843KYMDEmergency Medicine Physician
55213KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC CurrentSince Mar 1, 2021 Accepting new patients
T J Health Columbia Inc CurrentSince Dec 6, 2025 Accepting new patients
T J Health Columbia Inc Current Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Mar 1, 2020 Accepting new patients
Urgent Care Services Southeast PSC Family Medicine CurrentSince Oct 1, 2023 Accepting new patients
T J Samson Community Hospital Family Medicine CurrentSince May 1, 2020 Accepting new patients
T J Samson Community Hospital Current Accepting new patients
T J Health Columbia Inc Current Accepting new patients
T J Health Columbia Inc Current Accepting new patients
T J Samson Community Hospital Current Accepting new patients
T J Health Columbia Inc Current Accepting new patients
T J Health Columbia Inc CurrentSince Dec 6, 2025 Accepting new patients
T J Samson Community Hospital Past Accepting new patients

Locations

901 Wellness Way
Columbia, KY 42728
Phone (270) 384-4753

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141

1325 N Race St
Glasgow, KY 42141
Phone (270) 651-4797

310 N L Rogers Wells Blvd
Glasgow, KY 42141
Phone (270) 651-1111

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

360 Amsden Ave
Versailles, KY 40383
Phone (606) 873-3111

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1639666571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 WINTER PARK PL",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427018396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N L ROGERS WELLS BLVD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411300",
            "telephone_number": "270-659-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1325 N Race St",
            "address_purpose": "LOCATION",
            "city": "Glasgow",
            "state": "KY",
            "postal_code": "421413427",
            "country_code": "US",
            "telephone_number": "270-651-4865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENDER",
        "first_name": "DILLON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-17",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "R4843",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "55213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100603490",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K300041",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glasgow, KY

Sources for this page

Verify at the official NPI Registry.