Individual provider Active NPI

Wendy Ann Dillon, P.A.-C

  • Surgical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1962647305
Registry record updated Dec 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
C03840 Issued in MD
Practice address
2435 W Belvedere Ave
Suite 42
Baltimore, MD 21215-5224
Phone
(410) 601-5523
Fax
(410) 601-8946
NPI assigned
Dec 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X C03840 MD Primary

Addresses

Primary practice location

2435 W Belvedere Ave
Suite 42
Baltimore, MD 21215-5224

Mailing address

2401 W Belvedere Ave
Credentialing
Baltimore, MD 21215-5216
Phone (410) 601-5523

Other names 1

  • Wendy Ann Rogers Former name

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)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: wdillon547959@direct.umm.edu

NPI Registry JSON

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

{
    "created_epoch": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229299200000",
    "number": "1962647305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "address_2": "CREDENTIALING",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-5523",
            "fax_number": "410-601-8946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 W BELVEDERE AVE",
            "address_2": "SUITE 42",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155224",
            "telephone_number": "410-601-5523",
            "fax_number": "410-601-8946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "WENDY",
        "middle_name": "ANN",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-15",
        "last_updated": "2008-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C03840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "ROGERS",
            "middle_name": "ANN",
            "credential": "P.A.-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; 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.