Form Associates, P.A.
NPI 1003636143 · Endocrinology, Diabetes & Metabolism Physician · Wichita, KS
Form Associates, P.A. is a Endocrinology, Diabetes & Metabolism Physician organization in Wichita, KS (NPI 1003636143).
Provider details
- NPI number
- 1003636143
- Entity type
- Organization
- Primary specialty
- Endocrinology, Diabetes & Metabolism PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Troy Russell, Owner(617) 505-1520
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2024-10-14
- Last updated
- 2026-03-18
- Certified
- 2026-03-18
Frequently asked questions
- What is Form Associates, P.A.'s NPI number?
- Form Associates, P.A.'s National Provider Identifier (NPI) is 1003636143, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Form Associates, P.A.?
- Form Associates, P.A. is classified in the NPPES registry as Endocrinology, Diabetes & Metabolism Physician (Allopathic & Osteopathic Physicians).
- Where is Form Associates, P.A. located?
- Form Associates, P.A.'s practice location on file with NPPES is 801 E Douglas Ave Fl 2, Wichita, KS 67202-3548.
- What is Form Associates, P.A.'s phone number?
- The practice phone number listed in the NPPES registry for Form Associates, P.A. is (617) 505-1520.
- Who is the authorized official for Form Associates, P.A.?
- The authorized official listed on Form Associates, P.A.'s NPPES record is Troy Russell, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Form Associates, P.A.'s NPI active?
- Yes — Form Associates, P.A.'s NPI (1003636143) is active in the NPPES registry as of the last update on 2026-03-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.