Unknown Individual – Emergency Medicine Physician, NPI 1336242684

Unknown Individual is a healthcare provider. based in Kremmling, Colorado. specializing in Emergency Medicine Physician. They hold a License No. DR44221 (CO). The NPI Number for Unknown Individual is 1336242684

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1336242684
Phone
(970) 724-3442
Address
214 SOUTH 4TH STREET, P.O. BOX 399
Deactivation Date
20 September 2023

Doctor Profile

Medical School Name
WEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE
Secondary Phone
5413472426
Graduation Year
1981 (45 years ago)
PAC ID
0143273375
Group Practice PAC ID
1951219310
Professional Enrollment ID
I20081204000686
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

  • 214 SOUTH 4TH STREET, P.O. BOX 399

    KREMMLING MEMORIAL HOSPITAL

    KREMMLING, CO 80459

    Phone: (970) 724-3442

    Fax: (970) 724-9606

    Type: Mailing

  • 214, 4th Street, Kremmling, Grand County, Colorado, 80459, United States

    KREMMLING MEMORIAL HOSPITAL

    KREMMLING, CO 80459

    Phone: (970) 724-3442

    Fax: (970) 724-9606

    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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making5249$0
99284Emergency department visit with moderate level of medical decision making3737$0
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Insurance plans in this area (ZIP 80459)

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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: 1951219310View full group profile
NameSpecialtyState
Emergency MedicineCA
Family PracticeOR
Family PracticeOR
-OR
Diagnostic Radiology, Interventional RadiologyOR
Nurse PractitionerKY
Family Practice, Obstetrics/GynecologyCO
Family PracticeOR
Emergency MedicineOR
-OR

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1336242684 as the unique 10-digit identifier.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Kremmling, Colorado as the reference point for Unknown Individual, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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