Unknown Individual – Internal Medicine Physician, NPI 1003235011

Internal Medicine Physician

Unknown Individual is a healthcare provider. based in Little rock, Arkansas. specializing in Internal Medicine Physician. They hold a License No. E-11014 (AR). The NPI Number for Unknown Individual is 1003235011

Main info

Organization

Inactive

12 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1003235011

Phone

(501) 686-8000

Address

4301 W MARKHAM ST # 783

Deactivation Date

4 February 2022

Doctor Profile

Medical School Name

UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE

Secondary Phone

Graduation Year

2014 (12 years ago)

PAC ID

9537486774

Group Practice PAC ID

4082528955

Professional Enrollment ID

I20180130001420

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

4301 W MARKHAM ST # 783
LITTLE ROCK, AR 722057101
Phone: (501) 686-8000
Type: Mailing
4301 W MARKHAM ST
LITTLE ROCK, AR 722057101
Phone: (501) 686-5356
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72205)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 4082528955View full group profile

Name	Specialty	State
SUKANTHI KOVVURU	N E U R O L O G Y	AR
ASIS SHRESTHA (MD)	Internal Medicine	NY
JOHN M ARTHUR (MD)	Internal Medicine, Nephrology	AR
DR. UMA MAHESH MATAPATHI (M.D)	Diagnostic Radiology	AR
MANISH GOPE RAISINGANI	-	AR
CARL PRESTON MCCORMACK (MD)	-	AR
REBECCA A CAMP	Nurse Practitioner	AR
DR. JON RUBENOW (MD)	P S Y C H I A T R Y	AR
KATHRYN NEWTON ROWLEY (APN)	-	AR
KELSEY AGRE (APRN)	-	AR

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?

NPI numbers are unique to each provider or organization — Unknown Individual uses 1003235011.

Is Unknown Individual's NPI deactivated?

The extract indicates Unknown Individual is not in an active NPI state.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Internal Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.

Does Unknown Individual list a practice location?

Patients near Little Rock, Arkansas may find Unknown Individual in results; validate coverage separately.

How many locations tie to this NPI?

2 practice locations appear in the available data.