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DERBY DERM
NPI 1871771998
Physician Assistant in Derby, KS

Active since January 31, 2008CLIA 17D1097910 · Waiver
1121 N COLLEGE PARK ST, SUITE # 400, DERBY, KS 67037(316) 788-3376(316) 788-3378 Get Directions Write a Review

NPPES record last updated: January 31, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Derby Derm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERBY DERM (NPI 1871771998) is a healthcare organization registered as a physician assistant in Derby, Kansas and active in the NPI registry since January 2008. The organization holds a CLIA Waiver certificate valid through January 6, 2028 and lists Tim Weide, President, as its authorized official.

NPPES Registry Identity

NPI1871771998
Entity TypeOrganization
Primary Taxonomy363A00000X
Legal Business NameDERBY DERM
Location Address1121 N COLLEGE PARK ST, SUITE # 400Derby, KS 67037-3665
Mailing Address1121 N College Park St, Suite # 400Derby, KS 67037-3665 · (316) 788-3376 · Fax (316) 788-3378
Phone(316) 788-3376
Fax(316) 788-3378
Organization SubpartNo
Authorized OfficialTim WeidePresident · (316) 788-3376
Enumeration DateJanuary 31, 2008
✔ NPI 1871771998 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in KS · 1500761
Definition
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.
1121 N COLLEGE PARK ST, Derby, KS 67037
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 17D1097910

Derby Derm · Derby, KS
Active · expires Jan 6, 2028
CLIA Number17D1097910
Laboratory TypePractitioner Other
Certificate Effective DateJanuary 7, 2026
Certificate Expiration DateJanuary 6, 2028
Laboratory DirectorTim L. Weide
Laboratory Phone(316) 788-3376
Laboratory LocationDerby Derm1121 North College Park, Suite 400, Derby, KS 67037
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAMILLUS WELLNESS LLC
Dermatology
1121 N COLLEGE PARK ST
DERBY, KS 67037
Sedgwick County (316) 788-3376
JENNIFER T ALLEN APRN
Nurse Practitioner (Family)
1121 N COLLEGE PARK ST
DERBY, KS 67037
Sedgwick County (316) 788-3376
MRS. LINDSEY ANN MOSS LSCSW
Social Worker
1121 N COLLEGE PARK ST, SUITE 200
DERBY, KS 67037
Sedgwick County (316) 650-5737
MR. TIMOTHY L. WEIDE P.A.
Physician Assistant
1121 N COLLEGE PARK ST, SUITE # 400
DERBY, KS 67037
Sedgwick County (316) 788-3376

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derby Derm's NPI number?

The NPI number for Derby Derm is 1871771998. It was assigned to this organization in the NPPES registry on January 31, 2008.

Where is Derby Derm located?

Derby Derm is located at 1121 N College Park St Suite # 400, Derby, KS 67037. The listed phone number is (316) 788-3376.

What is Derby Derm's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Does Derby Derm hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 17D1097910) is associated with this NPI, valid through January 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Derby Derm accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 1 other insurer list Derby Derm as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Derby Derm was last updated on January 31, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.