Organization Active NPI

Richard Douglas Iliff MD PA

  • Family Medicine Physician
  • Topeka, KS
National Provider Identifier
1306985064
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
KS1500243 Issued in KS
Legal business name
RICHARD DOUGLAS ILIFF MD PA
Practice address
1119 SW Gage Blvd
Topeka, KS 66604-1999
Phone
(785) 271-6161
Fax
(785) 271-6414
NPI assigned
Feb 6, 2007
Last updated
Jul 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Authorized official

Name
Dr. Richard Douglas Iliff, MDNPI 1184692386
Title
President
Phone
(785) 271-6161

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X KS0418610 KS
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X KS1500243 KS Primary

Addresses

Primary practice location

1119 SW Gage Blvd
Topeka, KS 66604-1999

Mailing address

1119 SW Gage Blvd
Topeka, KS 66604-1999
Phone (785) 271-6161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190729003137 KS Part B Supplier - Clinic/Group Practice 5294061271 Receives reassigned benefits from 2 practitioners
Practice locations: Topeka, KS

National Provider Directory

National Provider Directory

Locations

1119 SW Gage Blvd
Topeka, KS 66604
Phone (785) 271-6161

Practitioners & affiliated clinicians

Practitioners 2

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": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564444800000",
    "number": "1306985064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 SW GAGE BLVD",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666041999",
            "telephone_number": "785-271-6161",
            "fax_number": "785-271-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 SW GAGE BLVD",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666041999",
            "telephone_number": "785-271-6161",
            "fax_number": "785-271-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD DOUGLAS ILIFF MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2019-07-30",
        "status": "A",
        "authorized_official_last_name": "ILIFF",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "785-271-6161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "KS0418610",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "KS1500243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Topeka, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.