Deidre Rose Dorman, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01058517A Issued in IN

Practice address

1500 W Neely Ave
Ball State University Student Health Center
Muncie, IN 47306-0001

Phone

(765) 285-8431

Fax

(765) 285-1103

NPI assigned

Oct 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: drdorman@direct.iuhealth.org

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.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Open Door Health Services, Inc.

  dba Open Door Health Services Blackford County

  • Federally Qualified Health Center (FQHC)
  • Hartford City, IN
  • NPI 1245094028
  NPD (past)
• Southside Emergency Associates

  • Personal Emergency Response Attendant
  • Indianapolis, IN
  • NPI 1053366922
  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1275621229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W NEELY AVE",
            "address_2": "BALL STATE UNIVERSITY STUDENT HEALTH CENTER",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473060001",
            "telephone_number": "765-285-8431",
            "fax_number": "765-285-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORMAN",
        "first_name": "DEIDRE",
        "middle_name": "ROSE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01058517A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200478710",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drdorman@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1500 Neely Ave",
            "address_2": "Ball State University Student Health Center",
            "city": "Muncie",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473060001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert Doggette, M.D.
• Robert M Domke, MD
• Beau Ryan Donahue
• Ericah Dongu
• Jesse Dority, MD
• Lisa L. Dornick, ARNP
• Michael A Dorsch, PA
• Layla Brielle Doss
• Jasmine Nowell Doucette
• Zane Doughty

• Family Medicine Physician in Muncie, IN
• Providers in Muncie, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.