NPIMap

Organization Active NPI

Johnson County Imaging Center LLC

  • Diagnostic Radiology Physician
  • Overland Park, KS
National Provider Identifier
1720135114
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
JOHNSON COUNTY IMAGING CENTER LLC
Practice address
11717 W 112TH St
Overland Park, KS 66210-2761
Phone
(913) 469-8998
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Authorized official

Name
Richard Miller, MDNPI 1164537346
Title
Owner
Phone
(913) 599-6777

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

11717 W 112TH St
Overland Park, KS 66210-2761

Mailing address

11717 W 112TH St
Overland Park, KS 66210-2761
Phone (913) 469-8998

Other identifiers 2

IdentifierTypeStateIssuer
CS2471OtherRR MEDICARE
100204610AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO, HI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20051027000420 KS Part B Supplier - Clinic/Group Practice 8628978053 Receives reassigned benefits from 34 practitioners
Practice locations: Louisburg, KS; Mission Hills, KS; Overland Park, KS; Prairie Village, KS; Roeland Park, KS; Stilwell, KS; Lenexa, KS; Leawood, KS…
O20200611000316 MO Part B Supplier - Clinic/Group Practice 8628978053 Receives reassigned benefits from 33 practitioners
Practice locations: Ozark, MO; Liberty, MO; Lees Summit, MO; Kansas City, MO; Belton, MO
O20260219001675 HI Part B Supplier - Clinic/Group Practice 8628978053 Receives reassigned benefits from 1 practitioner
Practice locations: Haiku, HI

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
17D1087900Johnson County Imaging Center11717 West 112TH Street, Overland Park, KS 66210Certificate of waiverAug 12, 2026

National Provider Directory

National Provider Directory

Locations

11221 Roe Ave
Leawood, KS 66211

11717 W 112th St
Overland Park, KS 66210

11221 Roe Ave
Ste 220
Overland Park, KS 66211

5300 Indian Creek Pkwy
Overland Park, KS 66207
Phone (913) 456-5274

3210 NE Carnegie Dr
Lees Summit, MO 64064

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768780800000",
    "number": "1720135114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11717 W 112TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102761",
            "telephone_number": "913-469-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11717 W 112TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102761",
            "telephone_number": "913-469-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON COUNTY IMAGING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-599-6777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR  MEDICARE",
            "identifier": "CS2471",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100204610A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.