Ian Shepherd Dorman

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

Practice address

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504

Phone

(210) 916-8040

NPI assigned

Jan 9, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1184434409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-8040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 Schofield Rd",
            "address_purpose": "LOCATION",
            "city": "Jbsa Ft Sam Houston",
            "state": "TX",
            "postal_code": "782347577",
            "country_code": "US",
            "telephone_number": "210-916-8040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "306 Liberty View Ln",
            "address_purpose": "LOCATION",
            "city": "Lynchburg",
            "state": "VA",
            "postal_code": "245022291",
            "country_code": "US",
            "telephone_number": "434-592-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Wilford Hall Loop",
            "address_purpose": "LOCATION",
            "city": "Jbsa Lackland",
            "state": "TX",
            "postal_code": "782365638",
            "country_code": "US",
            "telephone_number": "210-916-8040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORMAN",
        "first_name": "IAN",
        "middle_name": "SHEPHERD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Thomas Deyo
• David Richard Deysher, DO
• Jon Dietrich, M.D.
• Lennis K. Dippel, MD
• Megan Lynn Donahue, M.D.
• Tyler Doty, DO
• David Roland Drysdale, DO
• Thomas Michael Duginski, M.D.
• David Dulaney, MD
• Tyler David Dumars, LCSW

• Military Health Care Provider in Jbsa Ft Sam Houston, TX
• Providers in Jbsa Ft Sam Houston, TX by specialty
• Military Health Care Provider in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.