MD Diversified Services LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

04-26778 Issued in KS

Legal business name

MD DIVERSIFIED SERVICES LLC

Doing business as

Theo J Felts, MD

Practice address

23401 Prairie Star Pkwy
Suite 120
Lenexa, KS 66227-7268

Phone

(913) 676-8600

Fax

(913) 676-8601

NPI assigned

Jun 9, 2006

Last updated

Aug 4, 2010By 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

Theo J Felts, MD

Title

Sole Member LLC

Phone

(913) 322-8859

Specialties & licenses 1

Addresses

Other names 1

• THEO J FELTS, MD Doing business as

Locations

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280880000000",
    "number": "1871534248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 W 151ST ST",
            "address_2": "41",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662232231",
            "telephone_number": "913-322-8859",
            "fax_number": "888-778-9471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23401 PRAIRIE STAR PKWY",
            "address_2": "SUITE 120",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662277268",
            "telephone_number": "913-676-8600",
            "fax_number": "913-676-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD DIVERSIFIED SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2010-08-04",
        "status": "A",
        "authorized_official_last_name": "FELTS",
        "authorized_official_first_name": "THEO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE MEMBER LLC",
        "authorized_official_telephone_number": "913-322-8859",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-26778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THEO J FELTS, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Lenexa, KS
• Providers in Lenexa, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.