Shane Keith Dillon
Individual provider Active NPI Personal Care Attendant · Red Jacket, WV
NPI 1982203725 · NPPES record last updated Oct 22, 2020
Key facts
- NPI
- 1982203725
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- Shop Hollow Route 6 Mate Creek
Red Jacket, WV 25692 - Phone
- (304) 426-4722
- NPI assigned
- Oct 22, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Yes |
Addresses
Primary practice location
Shop Hollow Route 6 Mate Creek
Red Jacket, WV 25692
Mailing address
PO Box 80
Red Jacket, WV 25692-0080
Phone (304) 426-4722
Other providers in Red Jacket, WV
- Jenna Danielle Bryant
- Wigberto C Camomot
- Tonya Lynn Casey
- Shayla Raeann Cox
- Dylan Shaye Doyle
- Jagger Heath Doyle
- Tabitha Leann Ferguson
- Sherry Renee Gross
- Darlene NMN Hensley
All providers in Red Jacket, WV · Personal Care Attendant in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.