Individual provider Active NPI

Donald Dillard

  • Clinical Social Worker
  • Dallas, TX
National Provider Identifier
1902964166
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S17112 Issued in TX
Practice address
5402 Arapaho Rd
Dallas, TX 75248-6905
Phone
(972) 437-9950
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X S17112 TX Primary

Addresses

Primary practice location

5402 Arapaho Rd
Dallas, TX 75248-6905

Mailing address

5402 Arapaho Rd
Dallas, TX 75248-6905

Other identifiers 1

IdentifierTypeStateIssuer
S17112OtherTXLICENSE NUMBER

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070206000315 TX Practitioner - Clinical Social Worker 6204838196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jewish Family Service of Dallas, IncGroup PAC ID 3274504808, 17 clinicians

Practice addresses (Care Compare)

16301 Quorum Dr
Suite B2200
Addison, TX 75001-5978

5402 Arapaho Rd
Dallas, TX 75248-6905
Phone (972) 437-9950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17112TXMDProfessional Counselor
S17112TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Service of Dallas, Inc CurrentSince Feb 1, 2015 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: donald.dillard.1@27034.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902964166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5402 ARAPAHO RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752486905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5402 ARAPAHO RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752486905",
            "telephone_number": "972-437-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLARD",
        "first_name": "DONALD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "S17112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "S17112",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.