Active NPI
Kenneth E Dorsey, MD
- Dermatology Physician
- Houston, TX
National Provider Identifier
1477649754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- K1811
- Practice address
- 560 Meyerland Plaza Mall
Houston, TX 77096-1615 - Phone
- (713) 442-1615
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Procedural Dermatology Physician | 207NS0135X | K1811 | TX | |
| Dermatology Physician | 207N00000X | K1811 | TX | Primary |
Addresses
Primary practice location
560 Meyerland Plaza Mall
Houston, TX 77096-1615
Mailing address
11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000
Other practice location 1
2515 Business Center Dr
Pearland, TX 77584-2294
Phone (713) 442-7200
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102504106 | Medicaid | TX | |
| 102504101 | Medicaid | TX | |
| 102504104 | Medicaid | TX |
Electronic endpoints 4
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kdorsey2085@direct.kelsey-seybold.com | Direct | |
| FHIR URL | https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | |
| Direct Messaging Address | kdorsey2085@direct.kelsey-seybold.com | Direct | |
| FHIR URL | https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K1811 | TX | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Village Chiropractic and Wellness P.L.L.C. | 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.
-
- Chiropractor
- League City, TX
- NPI 1972750719
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623024000000",
"number": "1477649754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11511 SHADOW CREEK PKWY",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775847298",
"telephone_number": "713-442-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 MEYERLAND PLAZA MALL",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770961615",
"telephone_number": "713-442-1615"
}
],
"practiceLocations": [
{
"address_1": "2515 Business Center Dr",
"address_purpose": "LOCATION",
"city": "Pearland",
"state": "TX",
"postal_code": "775842294",
"country_code": "US",
"telephone_number": "713-442-7200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DORSEY",
"first_name": "KENNETH",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2021-06-07",
"certification_date": "2021-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "TX",
"license": "K1811",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "TX",
"license": "K1811",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102504106",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102504101",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102504104",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kdorsey2085@direct.kelsey-seybold.com",
"affiliation": "N",
"endpointDescription": "digital contact information",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "560 Meyerland Plaza Mall",
"city": "Houston",
"state": "TX",
"country_code": "US",
"postal_code": "770961615",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR endpoint URL",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2515 Business Center Dr",
"city": "Pearland",
"state": "TX",
"country_code": "US",
"postal_code": "775842294",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kdorsey2085@direct.kelsey-seybold.com",
"affiliation": "N",
"endpointDescription": "digital contact information",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2515 Business Center Dr",
"city": "Pearland",
"state": "TX",
"country_code": "US",
"postal_code": "775842294",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR endpoint URL",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "560 Meyerland Plaza Mall",
"city": "Houston",
"state": "TX",
"country_code": "US",
"postal_code": "770961615",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.