# TALLGRASS IMAGING ASSOCIATES, L.L.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Tallgrass Diagnostic Imaging
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124103379
- **Authorized official:** RANDY WAYNE WICKERSHAM (VP OF OPERATIONS)
- **Authorized official phone:** (405) 418-2200

## Contact information

- **Practice address:** 7111 E 21ST ST N, SUITE B, WICHITA, KS 67206-1078
- **Practice address phone:** (316) 925-4624
- **Practice address fax:** (316) 925-4625
- **Mailing address:** 7111 E 21ST ST N, SUITE B, WICHITA, KS 67206-1078
- **Mailing address phone:** (316) 925-4624
- **Mailing address fax:** (316) 925-4625

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | KS | Yes |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 08/22/2020