FORM ASSOCIATES, P.A.
FORM ASSOCIATES, P.A. is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1003636143, based in Wichita, KS. It is classified under Endocrinology, Diabetes & Metabolism Physician.
Getting there
Here is what surrounds this office in Wichita, based on OpenStreetMap data collected Oct 1, 2026. Parking is available about 338 ft away. If you arrive early, there is a coffee shop 0.32 mi away.
Getting here and what is nearby
Parking 73 ft ~1 min
Parking 303 ft ~2 min
Parking 338 ft ~2 min
Restaurant Larkspur 383 ft ~2 min
904 East Douglas Avenue, Wichita
Restaurant Beacon Restaurant 421 ft ~2 min
Restaurant District Taqueria 456 ft ~2 min
917 East Douglas Avenue, Wichita 67202
Gas station QuikTrip 797 ft ~4 min
1010 East Douglas Avenue, Wichita 67214
Convenience QuikTrip 829 ft ~4 min
1010 East Douglas Avenue, Wichita 67214
Convenience Ray Sales Company 0.24 mi ~5 min
206 South Emporia Street, Wichita 67202
Hotel Hilton Garden Inn Wichita Downtown 0.30 mi ~7 min
Coffee Starbucks 0.31 mi ~7 min
Hotel Courtyard by Marriott Wichita at Old Town 0.31 mi ~7 min
Coffee Scooters 0.32 mi ~7 min
311 North Washington Avenue, Wichita 67202
Coffee Scooter's Coffee 0.32 mi ~7 min
311 North Washington Avenue, Wichita 67202
Hotel AC Hotel Wichita Downtown 0.40 mi ~9 min
Distances are straight‑line estimates — walking routes may be longer. Hours and phone numbers can change; call ahead to confirm.
Credentials and Medicare
NPPES does not list a state licence number for this record. That is not unusual — organizations and some provider types are not required to file one. Verify current licensure with the relevant state board before care.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
What Endocrinology, Diabetes & Metabolism covers
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. NUCC Health Care Provider Taxonomy, code 207RE0101X
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1003636143 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Oct 14, 2024 |
| Last updated | Mar 18, 2026 |
| Status | Active |
| Practice address |
801 E DOUGLAS AVE FL 2 Wichita, KS 67202 (617) 505-1520 Fax (617) 928-8401 |
| Mailing address |
109 STATE STREET 5TH FL Boston, MA 02109 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 0 | 3 | 6 | 3 | 6 | 1 | 4 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 0 | 3 | 3 | 3 | 3 | 1 | 8 |
Sum = 47 · next multiple of 10 = 50 · check digit = 3 · actual last digit = 3
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.