DERBY DERM
NPI 1871771998
Physician Assistant in Derby, KS

NPI Status: Active since January 31, 2008

Contact Information

1121 N COLLEGE PARK ST
SUITE # 400
DERBY, KS
ZIP 67037
Phone: (316) 788-3376
Fax: (316) 788-3378

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  • Organization
  • Physician Assistant
  • Accepts Insurance
  • CLIA Number: 17D1097910
  • CLIA Cert. Type: Practitioner Other
  • CLIA Exp. Date: 01-06-2028

About DERBY DERM

This page provides the complete NPI Profile along with additional information for Derby Derm, a primary care provider established in Derby, Kansas operating as a Physician Assistant. The healthcare provider is registered in the NPI registry with number 1871771998 assigned on January 2008. The practitioner's primary taxonomy code is 363A00000X with license number 1500761 (KS). The provider is registered as an organization and their NPI record was last updated 18 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mr. Tim Weide P.a. (President)

NPI
1871771998
Provider Name
DERBY DERM
Entity Type
Organization
Location Address
1121 N COLLEGE PARK ST SUITE # 400 DERBY, KS 67037
Location Phone
(316) 788-3376
Location Fax
(316) 788-3378
Mailing Address
1121 N COLLEGE PARK ST SUITE # 400 DERBY, KS 67037
Mailing Phone
(316) 788-3376
Mailing Fax
(316) 788-3378
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-31-2008
Last Update Date
01-31-2008
Code Navigator

A primary care provider (PCP) like Derby Derm sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, 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

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
1500761
License State
KS
Taxonomy Description
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - EPO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • BlueCare EPO Bronze - EPO
  • BlueCare EPO Gold - EPO
  • BlueCare EPO Gold Plus - EPO
  • BlueCare EPO Silver Plus - EPO
  • BlueCare EPO Simple Bronze HDHP - EPO
  • BlueCare EPO Simple Silver HDHP - EPO
  • BlueCare EPO Standardized Expanded Bronze - EPO
  • BlueCare EPO Standardized Gold - EPO
  • BlueCare EPO Standardized Silver - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. TIM WEIDE P.A.

Authorized Official Title
PRESIDENT
Authorized Official Phone
(316) 788-3376

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
17D1097910
Facility Type
Practitioner Other
Certificate Effective Date
January 07, 2026
Certificate Expiration Date
January 06, 2028
Laboratory Director
TIM L. WEIDE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Derby Derm to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for DERBY DERM

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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 1871771998, we treat the final digit (8) 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 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).

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.

Pos 1
1
Doubled → 2
Pos 2
8
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
1
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
7
Unchanged
Pos 7
1
Doubled → 2
Pos 8
9
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
8
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 7 → 14 → 5 7 → 14 → 5 1 → 2 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 8 + 1 + 4 + 1 + 1 + 4 + 7 + 2 + 9 + 1 + 8 + 24 = 72

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 72 is 80. The difference is the calculated check digit.

80 - 72 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1871771998.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Physician Assistant
1121 N COLLEGE PARK ST, SUITE # 400
DERBY, KS 67037
Social Worker
1121 N COLLEGE PARK ST, SUITE 200
DERBY, KS 67037
Nurse Practitioner (Family)
1121 N COLLEGE PARK ST
DERBY, KS 67037

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1871771998, enumerated as an "organization" on January 31, 2008.

The provider is located at 1121 N COLLEGE PARK ST SUITE # 400 DERBY, KS 67037 and the phone number is (316) 788-3376.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from. Please consult your insurance carrier or call the provider to verify.