NPIMap

Organization Active NPI

Medical Imaging, PA

  • Diagnostic Radiology Physician
  • Kansas City, MO
National Provider Identifier
1124163795
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MEDICAL IMAGING, PA
Practice address
9501 N. Oak Trfy
Kansas City, MO 64155-2256
Phone
(816) 795-6179
NPI assigned
Feb 21, 2007
Last updated
Feb 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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

Authorized official

Name
Mr. John S. Dykstra, DONPI 1720061690
Title
Physician/Partner
Phone
(816) 455-0661

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

9501 N. Oak Trfy
Kansas City, MO 64155-2256

Mailing address

PO Box 414975
Kansas City, MO 64141-4975
Phone (913) 642-4900

Other identifiers 2

IdentifierTypeStateIssuer
0711198002MedicaidMO
07119026OtherMOBCBS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2005039Medical Imaging9501 N Oak Trafficway Ste 100, Kansas City, MO 64155Certificate of waiverMar 17, 2028

National Provider Directory

National Provider Directory

Locations

4400 Broadway Blvd
Ste 410
Kansas City, MO 64111
Phone (816) 756-0684

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264982400000",
    "number": "1124163795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 414975",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641414975",
            "telephone_number": "913-642-4900",
            "fax_number": "913-381-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 N. OAK TRFY",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641552256",
            "telephone_number": "816-795-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL IMAGING, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2010-02-01",
        "status": "A",
        "authorized_official_last_name": "DYKSTRA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PHYSICIAN/PARTNER",
        "authorized_official_telephone_number": "816-455-0661",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0711198002",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "07119026",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Feb 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.