Unknown Individual – Family Medicine Physician, NPI 1114989498

Unknown Individual is a healthcare provider. based in Searcy, Arkansas. specializing in Family Medicine Physician. They hold a License No. R1915 (AR). The NPI Number for Unknown Individual is 1114989498

Main info

Organization
Inactive
61 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1114989498
Phone
(501) 278-2808
Address
2900 HAWKINS DR
Deactivation Date
8 June 2022

Doctor Profile

Medical School Name
UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Secondary Phone
5012782800
Graduation Year
1965 (61 years ago)
PAC ID
6507909116
Group Practice PAC ID
4880688654
Professional Enrollment ID
I20100204000602
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Searcy Medical Center, 2900, Hawkins Drive, Searcy, White County, Arkansas, 72143, United States

    SEARCY, AR 721434802

    Phone: (501) 278-2808

    Fax: (501) 278-3001

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $21.

Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.

Last reported payment date: 2023-08-18 • Largest payer in this snapshot: Astellas Pharma US Inc ($21).

Total Amount

$21

General + Research + Ownership

Payments

1

Total payment records

General Amount

$21

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-08-18

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Astellas Pharma US Inc$21
View all Open Payments →|Open Payments Risk Radar →

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 72143)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEAR93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report2423

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: 4880688654View full group profile
NameSpecialtyState
Nurse PractitionerAR
P S Y C H I A T R YWY
Physician AssistantAR
Nurse PractitionerAR
Family PracticeAR
Emergency MedicineAR
Family PracticeAR
-AR
Physician AssistantAR
-AR

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1114989498 for Unknown Individual, then check state licensing separately.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Searcy, Arkansas in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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