FORM ASSOCIATES, P.A.
NPI 1003636143
Internal Medicine - Endocrinology, Diabetes & Metabolism in Wichita, KS
NPI Status: Active since October 14, 2024
Contact Information
801 E DOUGLAS AVE FL 2
WICHITA, KS
ZIP 67202
Phone: (617) 505-1520
Fax: (617) 928-8401
- Organization
- Internal Medicine
- Endocrinology, Diabetes & Metabolism
About FORM ASSOCIATES, P.A.
This page provides the complete NPI Profile along with additional information for Form Associates, P.a., an internist established in Wichita, Kansas operating as a Internal Medicine, focusing in endocrinology, diabetes & metabolism . The healthcare provider is registered in the NPI registry with number 1003636143 assigned on October 2024. The practitioner's primary taxonomy code is 207RE0101X. The provider is registered as an organization and their NPI record was last updated March 2026. Form Associates, P.a. operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Troy Russell Md (Owner)
- NPI
- 1003636143
- Provider Name
- FORM ASSOCIATES, P.A.
- Entity Type
- Organization
- Location Address
- 801 E DOUGLAS AVE FL 2 WICHITA, KS 67202
- Location Phone
- (617) 505-1520
- Location Fax
- (617) 928-8401
- Mailing Address
- 109 STATE STREET 5TH FL BOSTON, MA 02109
- Mailing Phone
- (617) 505-1520
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-14-2024
- Last Update Date
- 03-18-2026
- Code Navigator
An internist like Form Associates, P.a. is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Endocrinology, Diabetes & Metabolism
- Taxonomy Code
- 207RE0101X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1003636143, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 47. The final step is to find the difference between that total and the next multiple of ten (50 - 47 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 47 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
WICHITA, KS 67202
WICHITA, KS 67202
WICHITA, KS 67202
WICHITA, KS 67202
WICHITA, KS 67202
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003636143, enumerated as an "organization" on October 14, 2024.
The provider is located at 801 E DOUGLAS AVE FL 2 WICHITA, KS 67202 and the phone number is (617) 505-1520.
Internal Medicine with taxonomy code 207RE0101X and a focus in Endocrinology, Diabetes & Metabolism.
