Active NPI
Kelli Jo Dorsey, RN
- Registered Nurse
- Mason City, IA
National Provider Identifier
1003197526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 099268
- Practice address
- 235 S Eisenhower Ave
Mason City, IA 50401-1562 - Phone
- (641) 424-2075
- Fax
- (641) 424-9555
- NPI assigned
- Aug 30, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 099268 | IA | Primary |
Addresses
Primary practice location
235 S Eisenhower Ave
Mason City, IA 50401-1562
Mailing address
235 S Eisenhower Ave
Mason City, IA 50401-1562
Phone (641) 424-2075
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 099268 | IA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellsource | Registered Nurse | Past | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314662400000",
"number": "1003197526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 S EISENHOWER AVE",
"city": "MASON CITY",
"state": "IA",
"postal_code": "504011562",
"telephone_number": "641-424-2075",
"fax_number": "641-424-9555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 S EISENHOWER AVE",
"city": "MASON CITY",
"state": "IA",
"postal_code": "504011562",
"telephone_number": "641-424-2075",
"fax_number": "641-424-9555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORSEY",
"first_name": "KELLI",
"middle_name": "JO",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-30",
"last_updated": "2011-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IA",
"license": "099268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mason City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.