NPIMap

Organization Active NPI

Prism Diagnostics, LLC

  • Clinical Medical Laboratory
  • Manhattan, KS
National Provider Identifier
1063907376
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PRISM DIAGNOSTICS, LLC
Practice address
1133 College Ave
Building C, Suite 145
Manhattan, KS 66502-2751
Phone
(785) 565-9500
Fax
(785) 565-9595
NPI assigned
Jun 28, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Authorized official

Name
Dr. Fadi V Bedros, MDNPI 1407893290
Title
Owner
Phone
(785) 565-9500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X KS Primary

Addresses

Primary practice location

1133 College Ave
Building C, Suite 145
Manhattan, KS 66502-2751

Mailing address

1133 College Ave
Building B, Suite 100
Manhattan, KS 66502
Phone (785) 565-9500

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530144000000",
    "number": "1063907376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 COLLEGE AVE",
            "address_2": "BUILDING B, SUITE 100",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "66502",
            "telephone_number": "785-565-9500",
            "fax_number": "785-565-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 COLLEGE AVE",
            "address_2": "BUILDING C, SUITE 145",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665022751",
            "telephone_number": "785-565-9500",
            "fax_number": "785-565-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISM DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A",
        "authorized_official_last_name": "BEDROS",
        "authorized_official_first_name": "FADI",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "785-565-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.