Unknown Individual – Psychiatry Physician, NPI 1366496309

Unknown Individual is a healthcare provider. based in Johnstown, Colorado. specializing in Psychiatry Physician. They hold a License No. 39295 (CO). The NPI Number for Unknown Individual is 1366496309

Main info

Organization
Inactive
41 Years Of Experience
Name
Unknown Individual
NPI
1366496309
Phone
(970) 461-5061
Address
4770 LARIMER PKWY
Deactivation Date
13 September 2021

Doctor Profile

Medical School Name
UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Secondary Phone
9203281220
Graduation Year
1985 (41 years ago)
PAC ID
9335172485
Group Practice PAC ID
7517248198
Professional Enrollment ID
I20180103001909
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

  • Clear View Behaviorial Health, 4770, Larimer Parkway, Johnstown, Larimer County, Colorado, 80534, United States

    JOHNSTOWN, CO 805348918

    Phone: (970) 461-5061

    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 80534)

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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: 7517248198View full group profile
NameSpecialtyState
P S Y C H I A T R YWI
P S Y C H I A T R YNY
-WI
P S Y C H I A T R YNH
Nurse PractitionerWI
Nurse PractitionerWI
P S Y C H I A T R YWI
Nurse PractitionerWI

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1366496309 when you need to reference Unknown Individual in forms, claims, or directories.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Johnstown, Colorado for Unknown Individual; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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