Unknown Individual – Allergy & Immunology Physician, NPI 1891787974

Unknown Individual is a healthcare provider. based in Little rock, Arkansas. specializing in Allergy & Immunology Physician. They hold a License No. C5054 (AR). The NPI Number for Unknown Individual is 1891787974

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1891787974
Phone
(501) 224-1156
Address
18 CORPORATE HILL DR
Deactivation Date
21 June 2023

Doctor Profile

Medical School Name
UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Secondary Phone
5019042820
Graduation Year
1976 (50 years ago)
PAC ID
7810909892
Group Practice PAC ID
1658383633
Professional Enrollment ID
I20100511000249
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

  • 18, Corporate Hill Drive, Little Rock, Pulaski County, Arkansas, 72205, United States

    SUITE 110

    LITTLE ROCK, AR 722054549

    Phone: (501) 224-1156

    Fax: (501) 801-5561

    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)

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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Provider's Procedures

Unknown Individual performs procedures in Allergy & Immunology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ALLERGY/IMMUNOLOGYAR94060Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration3231
ALLERGY/IMMUNOLOGYAR95004Injection of allergenic extracts into skin, accessed through the skin460878

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: 1658383633View full group profile
NameSpecialtyState
A L L E R G Y/ I M M U N O L O G YAR
A L L E R G Y/ I M M U N O L O G YAR
Nurse PractitionerAR
A L L E R G Y/ I M M U N O L O G YIA
-AR
A L L E R G Y/ I M M U N O L O G YAR
A L L E R G Y/ I M M U N O L O G YLA
Allergy/Immunology, Pediatric MedicineAR

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1891787974 — the number used across U.S. healthcare to identify this provider.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Allergy & Immunology 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.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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