Individual provider Active NPI

Dillon J Pankey, OD

  • Student in an Organized Health Care Education/Training Program
  • Clinton, MS
National Provider Identifier
1871341974
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
115 Cynthia St
Clinton, MS 39056-3711
Phone
(601) 924-4444
NPI assigned
May 13, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

115 Cynthia St
Clinton, MS 39056-3711

Mailing address

115 Cynthia St
Clinton, MS 39056-3711
Phone (601) 924-4444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240920003666 MS Practitioner - Optometry 0749721439 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optical 2000Group PAC ID 8729983325, 4 clinicians
Optical 2000 of RichlandGroup PAC ID 1456439082, 4 clinicians

Practice addresses (Care Compare)

115 Cynthia St
Clinton, MS 39056-3711
Phone (601) 924-4444

655 Hwy 49 S
Suite M
Richland, MS 39218-8431
Phone (601) 932-3727

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optical 2000 CurrentSince Aug 10, 2024 Accepting new patients
Optical 2000 of Flora PA PastSince May 19, 2024 Accepting new patients

Locations

115 Cynthia St
Clinton, MS 39056
Phone (601) 924-4444

655 Highway 49 S
Ste M
Richland, MS 39218
Phone (601) 932-3727

Interoperability endpoints

  • Direct secure messaging: dillon.pankey.1@20428.direct.athenahealth.com

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": "1715558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1871341974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CYNTHIA ST",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390563711",
            "telephone_number": "601-924-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CYNTHIA ST",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390563711",
            "telephone_number": "601-924-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANKEY",
        "first_name": "DILLON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MS

Sources for this page

Verify at the official NPI Registry.