Individual provider Active NPI

Carminia Edralin Davidsohn, MD

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1831285113
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
J7462 Issued in TX
Practice address
13105 Wortham Center Dr
Houston, TX 77065-5611
Phone
(713) 442-4000
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X J7462 TX Primary

Addresses

Primary practice location

13105 Wortham Center Dr
Houston, TX 77065-5611

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other identifiers 3

IdentifierTypeStateIssuer
043597603MedicaidTX
043597604MedicaidTX
043597605MedicaidTX

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cdavidsohn701@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
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

Enrollment IDStateProvider typePAC IDDetails
I20031211000471 TX Practitioner - Internal Medicine 1850297631 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Internal Medicine CurrentSince Jan 1, 1999 Accepting new patients

Locations

1560 W Bay Area Blvd
Ste 100
Friendswood, TX 77546
Phone (713) 442-4400

13114 FM 1960 Rd W
Houston, TX 77065
Phone (281) 897-1701

13105 Wortham Center Dr
Bldg A
Houston, TX 77065

6624 Fannin St
Houston, TX 77030
Phone (713) 442-1500

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

13105 Wortham Center Dr
Houston, TX 77065
Phone (713) 442-4000

23000 Highland Knolls Blvd
Katy, TX 77494
Phone (713) 442-4200

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200

Interoperability endpoints

  • Direct secure messaging: cdavidsohn701@direct.kelsey-seybold.com

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1831285113",
    "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": "13105 WORTHAM CENTER DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770655611",
            "telephone_number": "713-442-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSOHN",
        "first_name": "CARMINIA",
        "middle_name": "EDRALIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J7462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043597603",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043597604",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043597605",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdavidsohn701@direct.kelsey-seybold.com",
            "affiliation": "N",
            "endpointDescription": "digital contact information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13105 Wortham Center Dr",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770655611",
            "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": "13105 Wortham Center Dr",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770655611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.