Unknown Individual – Foot Surgery Podiatrist, NPI 1487698478

Unknown Individual is a healthcare provider. based in Jonesboro, Arkansas. specializing in Foot Surgery Podiatrist. They hold a License No. 182 (AR). The NPI Number for Unknown Individual is 1487698478

Main info

Organization
Inactive
29 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1487698478
Phone
(870) 931-3338
Address
637 E MATTHEWS AVE
Deactivation Date
13 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8709313338
Graduation Year
1997 (29 years ago)
PAC ID
0042348534
Group Practice PAC ID
3577689637
Professional Enrollment ID
I20110208000803
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

  • 637, East Matthews Avenue, Jonesboro, Craighead County, Arkansas, 72401, United States

    JONESBORO, AR 724013145

    Phone: (870) 931-3338

    Fax: (870) 935-9084

    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 8 Open Payments records for all available years, with a total value of $226.

Total Amount is formed as General ($226) + Research ($0) + Ownership ($0) = $226.

Last reported payment date: 2024-05-03 • Largest payer in this snapshot: Organogenesis Inc. ($201).

Total Amount

$226

General + Research + Ownership

Payments

8

Total payment records

General Amount

$226

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-03

Latest reported date

Top Companies

Largest payers in this snapshot

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes594269$0
11721Removal of fingernails or toenails, 6 or more nails250118$0
99203New patient office or other outpatient visit, 30-44 minutes167167$0
73630X-ray of foot, minimum of 3 views9667$0
11042Removal of skin and tissue, 20.0 sq cm or less5311$0
View full utilization report →

Insurance plans in this area (ZIP 72401)

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Provider's Procedures

Unknown Individual performs procedures in Foot Surgery Podiatrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PODIATRYAR11720Removal of tissue from 1 to 5 finger or toe nails19699

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: 3577689637View full group profile
NameSpecialtyState
-AR

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1487698478 when you need to reference Unknown Individual in forms, claims, or directories.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What kind of provider is Unknown Individual?
The page reflects Foot Surgery Podiatrist for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Jonesboro, Arkansas for Unknown Individual; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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