Active NPI
Marlin L Dillard
- Prevention Professional
- Dayton, OH
National Provider Identifier
1770117954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- RS525863
- Practice address
- 5103 Bellefontaine Rd
Dayton, OH 45424-4163 - Phone
- (937) 405-3336
- NPI assigned
- Feb 27, 2020
- 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 |
|---|---|---|---|---|
| Prevention Professional | 405300000X | RS525863 | OH | Primary |
Addresses
Primary practice location
5103 Bellefontaine Rd
Dayton, OH 45424-4163
Mailing address
5103 Bellefontaine Rd
Dayton, OH 45424-4163
Phone (937) 405-3336
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RS525863 | OH | MD | Prevention Professional |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Priority Non-Medical Transportation | Current | Accepting new patients |
Organizations & group practices 1
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.
-
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- NPI 1306528138
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582761600000",
"number": "1770117954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5103 BELLEFONTAINE RD",
"city": "DAYTON",
"state": "OH",
"postal_code": "454244163",
"telephone_number": "937-405-3336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5103 BELLEFONTAINE RD",
"city": "DAYTON",
"state": "OH",
"postal_code": "454244163",
"telephone_number": "937-405-3336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLARD",
"first_name": "MARLIN",
"middle_name": "L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-02-27",
"last_updated": "2020-02-27",
"certification_date": "2020-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "OH",
"license": "RS525863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.