Organization Active NPI

Innovative Medical Solutions, Inc.

  • Diagnostic Radiology Physician
  • Kansas City, MO
National Provider Identifier
1013534049
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
INNOVATIVE MEDICAL SOLUTIONS, INC.
Doing business as
Dynamic Medical Solutions
Practice address
4218 Roanoke Rd Ste 304
Kansas City, MO 64111-4996
Phone
(816) 753-5459
NPI assigned
Jun 25, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Authorized official

Name
Mrs. Nicki J Theodoridis
Title
President
Phone
(816) 753-5459

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

4218 Roanoke Rd Ste 304
Kansas City, MO 64111-4996

Mailing address

3860 N Mulberry Dr Apt 5310
Kansas City, MO 64116-1894
Phone (816) 753-5459

Other names 1

  • Dynamic Medical Solutions Doing business as

National Provider Directory

National Provider Directory

Locations

4218 Roanoke Rd
Ste 304
Kansas City, MO 64111
Phone (816) 753-5119

NPI Registry JSON

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593043200000",
    "number": "1013534049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 N MULBERRY DR APT 5310",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641161894",
            "telephone_number": "816-753-5459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4218 ROANOKE RD STE 304",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641114996",
            "telephone_number": "816-753-5459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE MEDICAL SOLUTIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-25",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "THEODORIDIS",
        "authorized_official_first_name": "NICKI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-753-5459",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynamic Medical Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.