NPIMap

Organization Active NPI

Family Medcenters, P.a.

Doing business as FMC Diagnostic Center

  • Radiology Clinic/Center
  • Derby, KS
National Provider Identifier
1104022482
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
FAMILY MEDCENTERS, P.A.
Doing business as
FMC Diagnostic Center
Practice address
1101 N Rock Rd
Derby, KS 67037-3735
Phone
(316) 788-1134
Fax
(316) 788-5373
NPI assigned
Jun 25, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
David Wayne Niederee, M.D.
Title
President
Phone
(316) 788-6963

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

1101 N Rock Rd
Derby, KS 67037-3735

Mailing address

1101 N Rock Rd
Derby, KS 67037-3735
Phone (316) 788-1134

Other identifiers 1

IdentifierTypeStateIssuer
110528OtherKSBCBS OF KANSAS

Other names 1

  • FMC Diagnostic Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Derby Ambulatory Surgery5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104022482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N ROCK RD",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670373735",
            "telephone_number": "316-788-1134",
            "fax_number": "316-788-5373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N ROCK RD",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670373735",
            "telephone_number": "316-788-1134",
            "fax_number": "316-788-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDCENTERS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NIEDEREE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "316-788-6963",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KANSAS",
            "identifier": "110528",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FMC Diagnostic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Derby, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.