Unknown Individual – Pain Medicine (Anesthesiology) Physician, NPI 1528078490

Unknown Individual is a healthcare provider. based in Little rock, Arkansas. specializing in Pain Medicine (Anesthesiology) Physician. They hold a License No. E0337 (AR). The NPI Number for Unknown Individual is 1528078490

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1528078490
Phone
(501) 217-4000
Address
PO BOX 242807
Deactivation Date
28 January 2022

Doctor Profile

Medical School Name
UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
Secondary Phone
5017712799
Graduation Year
1976 (50 years ago)
PAC ID
4688699549
Group Practice PAC ID
7012987845
Professional Enrollment ID
I20070824000494
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • PO BOX 242807

    LITTLE ROCK, AR 722230032

    Phone: (501) 217-4000

    Fax: (501) 821-2473

    Type: Mailing

  • 1701 CENTERVIEW DR

    SUITE 200

    LITTLE ROCK, AR 722114308

    Phone: (501) 217-4000

    Fax: (501) 217-4022

    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 72223)

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Provider's Procedures

Unknown Individual performs procedures in Pain Medicine (Anesthesiology) Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ANESTHESIOLOGYAR64493Injections of lower or sacral spine facet joint using imaging guidance4424

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: 7012987845View full group profile
NameSpecialtyState
ANN MARIE ESTES HODGE (DNP)
Nurse PractitionerAR
Unknown Individual
Physical Therapist In Private PracticeAR
DR. SAINT ADEOGBA (M.D.)
Physical Medicine And RehabilitationAR
BUTCHAIAH GARLAPATI (M.D.)
Physical Medicine And Rehabilitation, Pain ManagementAR
MELANIE SHEVONNE BOLEN (DNP, APRN-CNP, FNP-C)
Nurse PractitionerAR
DEIDRE FORD (APRN, FNP-C)
Nurse PractitionerAR

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1528078490 on file in the registry.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Pain Medicine (Anesthesiology) Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Little Rock, Arkansas as the reference point for Unknown Individual, then confirm.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.