Prairie Creek Imaging LLC

Primary specialty

Body Imaging PhysicianTaxonomy code 2085B0100X

Legal business name

PRAIRIE CREEK IMAGING LLC

Practice address

500 S Main St
Wichita, KS 67202-3722

Phone

(316) 262-1103

NPI assigned

Mar 9, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Glen Shurtz, MD

Title

President

Phone

(316) 262-1103

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1245208008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2854",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672012854",
            "telephone_number": "316-685-3698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S MAIN ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672023722",
            "telephone_number": "316-262-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE CREEK IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "SHURTZ",
        "authorized_official_first_name": "GLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "316-262-1103",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA5653",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "110957",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.