John S. Dykstra X, DO

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

R4721 Issued in MO

Practice address

9501 N Oak Trfy
Suite 100
Kansas City, MO 64155-2256

Phone

(816) 455-0661

Fax

(816) 454-1080

NPI assigned

Nov 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northland Imaging, LLC

  • Radiology Clinic/Center
  • Kansas City, MO
  • NPI 1851441505
  NPD (past)
• Diagnostic Imaging Services, LLC

  • Radiology Clinic/Center
  • Wichita, KS
  • NPI 1437209160
  NPD (past)

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1720061690",
    "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": "816-455-0661",
            "fax_number": "816-454-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 N OAK TRFY",
            "address_2": "SUITE 100",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641552256",
            "telephone_number": "816-455-0661",
            "fax_number": "816-454-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKSTRA",
        "first_name": "JOHN",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "name_suffix": "X",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "R4721",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "0516561",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240394122",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2239077",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "03870079",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "067407",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100231260A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Ann Dye
• Jeffrey J. Dyer, M.D.
• Tracy Jane Dyer, MD
• Amanda Dyhouse, LMSW
• Jean Dykstra, DO
• Dynamic Unity Adult Daycare LLC
• Dynamic Unity CDS LLC
• Dynamic Unity Family Support
• Dynamic Unity Home Care LLC
• Meghan Nichole Dyster, OTD, OTR/L

• Diagnostic Radiology Physician in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Diagnostic Radiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; 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.