Nicole Kinis Dorsey

Key facts

NPI

1922708643

Entity type

Individual (NPI type 1)

Primary specialty

Community/Behavioral Health Agency 251S00000X

Practice address

44 Seminole St
Sorrento, FL 32776-9292

Phone

(321) 297-7337

NPI assigned

Mar 9, 2023

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 9, 2023.

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1922708643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 SEMINOLE ST",
            "city": "SORRENTO",
            "state": "FL",
            "postal_code": "327769292",
            "telephone_number": "321-297-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 SEMINOLE ST",
            "city": "SORRENTO",
            "state": "FL",
            "postal_code": "327769292",
            "telephone_number": "321-297-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORSEY",
        "first_name": "NICOLE",
        "middle_name": "KINIS",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Sorrento, FL · Community/Behavioral Health Agency in Florida