Individual provider Active NPI

Ross Dorsey, MSW, LCSW, LCAC

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1407416233
Registry record updated Jun 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34008937A Issued in IN
Practice address
26 N Arsenal Ave
Indianapolis, IN 46201-3808
Phone
(317) 632-0123
NPI assigned
Jun 14, 2019
Last updated
Jun 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33008217A IN
Clinical Social Worker 1041C0700X 34008937A IN Primary

Addresses

Primary practice location

26 N Arsenal Ave
Indianapolis, IN 46201-3808

Mailing address

26 N Arsenal Ave
Indianapolis, IN 46201-3808
Phone (317) 632-0123

Other identifiers 1

IdentifierTypeStateIssuer
300047183MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rdorsey@damien.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200909002565 IN Practitioner - Clinical Social Worker 2860810728 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33008217AINMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Damien Center Inc Clinical CurrentSince Aug 28, 2020 Accepting new patients

Locations

26 N Arsenal Ave
Indianapolis, IN 46201
Phone (317) 423-0123

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687564800000",
    "number": "1407416233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 N ARSENAL AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462013808",
            "telephone_number": "317-632-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 N ARSENAL AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462013808",
            "telephone_number": "317-632-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORSEY",
        "first_name": "ROSS",
        "credential": "MSW, LCSW, LCAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-14",
        "last_updated": "2023-06-24",
        "certification_date": "2023-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33008217A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008937A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300047183",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rdorsey@damien.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "26 N Arsenal Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462013808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.