NPIMap

Organization Active NPI

Dodge City Diagnostic, LLC

  • Specialist
  • Dodge City, KS
National Provider Identifier
1689699613
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
DODGE CITY DIAGNOSTIC, LLC
Practice address
2603 Central Avenue
Dodge City, KS 67801-6200
Phone
(620) 227-7771
NPI assigned
Jul 12, 2006
Last updated
Feb 24, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Authorized official

Name
Joni L Reiter
Title
Manager
Phone
(620) 227-7771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

2603 Central Avenue
Dodge City, KS 67801-6200

Mailing address

2603 Central Avenue
Dodge City, KS 67801-6200
Phone (620) 227-7771

Other identifiers 2

IdentifierTypeStateIssuer
1447259221OtherKSDR. ALEXANDER B. NEEL
100428180AMedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050407000748 KS Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8325095623 Practice locations: Dodge City, KS

National Provider Directory

National Provider Directory

Locations

2208 Summerlon Cir
Dodge City, KS 67801
Phone (620) 227-7771

2601 Central Ave
Bldg A
Dodge City, KS 67801
Phone (620) 227-7771

2603 Central Ave
Dodge City, KS 67801
Phone (513) 490-3643

Practitioners & affiliated clinicians

Practitioners 150

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 150

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456272000000",
    "number": "1689699613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 CENTRAL AVENUE",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678016200",
            "telephone_number": "620-227-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 CENTRAL AVENUE",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678016200",
            "telephone_number": "620-227-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DODGE CITY DIAGNOSTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2016-02-24",
        "status": "A",
        "authorized_official_last_name": "REITER",
        "authorized_official_first_name": "JONI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "620-227-7771"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. ALEXANDER B. NEEL",
            "identifier": "1447259221",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100428180A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dodge City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.