Andrea Marie Dillon, DPT

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT-1361 Issued in WY

Practice address

85 Sierra Park Rd
Mammoth Lakes, CA 93546-2073

Phone

(760) 734-7302

Fax

(760) 934-7302

NPI assigned

Feb 2, 2010

Sex

Female

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Excel Physical Therapy, LLC

  • Physical Therapist
  • Jackson, WY
  • NPI 1356414684

  Physical Therapy

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mahoadillon@mammothhospital.cernerdirect.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 11, 2021.

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1699007658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935460660",
            "telephone_number": "760-934-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SIERRA PARK RD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935462073",
            "telephone_number": "760-734-7302",
            "fax_number": "760-934-7302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-02",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WY",
            "license": "PT-1361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MAHOADILLON@MAMMOTHHOSPITAL.CERNERDIRECT.COM",
            "affiliation": "N",
            "endpointDescription": "Mammoth Hospital Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "120 West Pearl Avenue",
            "city": "Jackson",
            "state": "WY",
            "country_code": "US",
            "postal_code": "83001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jenna Lynne Arellano Cruz
• Esmeralda Lisset Curiel Gonzalez
• Karly Marie Dawson, PA-C, MSPAS, MPH
• Deanna S Dean, BSN, RN, CNOR, RNASC
• Bryan Dennison, P.T.
• Sheila Curry Donahue, LMT
• Kristen Anne Dorough, RNFA
• Dr Maria M. King Inc
• Gabrielle Duhl
• Iris Duran

• All providers in Mammoth Lakes, CA
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.