PRISM DIAGNOSTICS, LLC (NPI# 1063907376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063907376 |
| Entity Type | Organization |
| Organization Name | PRISM DIAGNOSTICS, LLC |
| Practice Address |
1133 College Ave Building C, Suite 145 Manhattan KS 66502-2751 |
| Mailing Address |
1133 College Ave Building B, Suite 100 Manhattan KS 66502 |
| Practice Telephone | 7855659500 |
| Practice Fax Number | 7855659595 |
| Mailing Telephone | 7855659500 |
| Mailing Fax Number | 7855659595 |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2018-06-28 |
| Authorized Official Name | DR. FADI V BEDROS (OWNER) |
| Authorized Official Telephone | 7855659500 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | KS | Laboratories |
| Street Address |
1133 COLLEGE AVE BUILDING C, SUITE 145 |
| City | MANHATTAN |
| State | KS |
| Zip Code | 66502-2751 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801899240 | Rosanne C Kreller | Nurse Practitioner | 1133 College Ave, Ste E230, Manhattan, KS 66502-2795 | 2005-05-31 |
| 1922615806 | Christina Guhr | Nurse Practitioner | 1133 College Ave, Manhattan, KS 66502-2770 | 2020-09-25 |
| 1417439977 | Kelli Renae Pettijohn | Physical Therapy Assistant | 1133 College Ave, Manhattan, KS 66502-2770 | 2018-08-31 |
| 1396266060 | Stacey L Marti | Physical Therapist | 1133 College Ave, Manhattan, KS 66502-2770 | 2017-07-03 |
| 1457891244 | Gilberto Magallanes | Occupational Therapy Assistant | 1133 College Ave, A213, Manhattan, KS 66502-2770 | 2017-02-28 |
| 1750826632 | Rachel Marie Irwin | Behavior Technician | 1133 College Ave, A213, Manhattan, KS 66503 | 2016-12-30 |
| 1255875852 | Dental Associates of Manhattan LLC | Dentist | 1133 College Ave, Suite D202, Manhattan, KS 66502-2770 | 2016-12-15 |
| 1457802613 | Laura Simons | Behavioral Analyst | 1133 College Ave, Manhattan, KS 66502-2770 | 2016-10-21 |
| 1528517901 | No Stone Unturned Foundation | Clinic/Center | 1133 College Ave, Suite A213, Manhattan, KS 66502-2770 | 2016-09-27 |
| 1225583099 | Kylene Caquelin | Behavioral Analyst | 1133 College Ave, A213, Manhattan, KS 66502-2770 | 2016-08-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184232217 | Rebecca Anne Cherry | Marriage & Family Therapist | 1506 Browning Avenue, Suite 107, Manhattan, KS 66502 | 2020-07-15 |
| 1992334361 | Lorin C Kelly | Counselor | 201 South 4th Street, Suite C5, Manhattan, KS 66502 | 2020-04-07 |
| 1306487947 | Emily Trausch | Specialist/Technologist | 18 Ahearn Fieldhouse, Manhattan, KS 66502 | 2019-10-04 |
| 1730741018 | Jessica Caroline Kostroske | Speech-Language Pathologist | 2031 Poyntz Avenue, Manhattan, KS 66502 | 2019-07-08 |
| 1962968420 | Sarah C Siders | Social Worker | 1506 Browning Avenue #107, Manhattan, KS 66502 | 2019-02-20 |
| 1215408331 | Sara E Gotchey | Registered Nurse | 2100 Claflin Rd, Manhattan, KS 66502 | 2018-12-16 |
| 1306315601 | Gail Elizabeth Webster | Midwife, Lay | 2106 Timber Creek Dr, Manhattan, KS 66502 | 2018-11-15 |
| 1972021525 | Patience Ivy | Student in an Organized Health Care Education/Training Program | 1615 Denison Ave, Apt 211, Manhattan, KS 66502 | 2017-09-05 |
| 1578086252 | Alexa Jean Sharr | Physician Assistant | 1404 Beechwood Ter Ste C and D, Manhattan, KS 66502 | 2017-07-25 |
| 1790226702 | Mackenzie Getz | Student in an Organized Health Care Education/Training Program | 2465 Vaughn Dr, Manhattan, KS 66502 | 2017-03-10 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346725637 | Excel Clinical Laboratory Service | Clinical Medical Laboratory | 1133 College Ave Ste 145, Manhattan, KS 66502-2770 | 2018-10-02 |
| 1114042512 | Kansas State Univeristy | Clinical Medical Laboratory | 1800 Denison Ave, Mosier Hall, Manhattan, KS 66506-5660 | 2007-03-21 |
| 1780756155 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1133 College Ave, Suite 131, Manhattan, KS 66502-2770 | 2006-11-14 |
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|---|---|---|---|---|
| 1497354575 | Lifetech Sciences LLC | Clinical Medical Laboratory | 2301 Nw Furman Rd Ste 100, Topeka, KS 66618-2845 | 2020-10-20 |
| 1811510027 | Clinical Reference Laboratory, Inc. | Clinical Medical Laboratory | 1121 W Old Highway 56, Olathe, KS 66061-5256 | 2020-05-21 |
| 1124667951 | Sinochips Kansas LLC | Clinical Medical Laboratory | 2002 W 39th Ave Ste G029, Kansas City, KS 66103-2943 | 2019-12-26 |
| 1023517174 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 3243 E Murdock Street, Level G, Wichita, KS 67214 | 2018-02-05 |
| 1831612670 | 4m Healthcare, LLC | Clinical Medical Laboratory | 15110 Glenwood Ave, Overland Park, KS 66223-3338 | 2017-07-24 |
| 1750753232 | Accurate Sleep Lab | Clinical Medical Laboratory | 411 S Pattie St Suite 2, Wichita, KS 67211 | 2015-10-23 |
| 1912386491 | Intelligenedx LLC | Clinical Medical Laboratory | 10900 S Clay Blair Blvd, Ste 1400, Olathe, KS 66061-1301 | 2015-05-29 |
| 1164835823 | Central Medical Laboratory, LLC | Clinical Medical Laboratory | 8960 Commerce Dr, Building 6, De Soto, KS 66018 | 2014-06-10 |
| 1891121943 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 507 16th Street, Suite #1, Wellington, KS 67152-2828 | 2013-09-20 |
| 1073956355 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 700 W Central Ave Ste 201, El Dorado, KS 67042-2186 | 2013-04-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.