Unknown Individual – Family Medicine Physician, NPI 1467436527

Family Medicine Physician

Unknown Individual is a healthcare provider. based in Lamar, Colorado. specializing in Family Medicine Physician. They hold a License No. 19136 (CO). The NPI Number for Unknown Individual is 1467436527

Main info

Organization

Inactive

53 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1467436527

Phone

(719) 336-0261

Address

201 KENDALL DR

Deactivation Date

14 August 2024

Doctor Profile

Medical School Name

AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE

Secondary Phone

7193360261

Graduation Year

1973 (53 years ago)

PAC ID

8325945652

Group Practice PAC ID

8527031533

Professional Enrollment ID

I20110524000360

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

Kendall Drive, Lamar, Prowers County, Colorado, 81052, United States
LAMAR, CO 810523939
Phone: (719) 336-0261
Fax: (719) 336-0265
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.

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

HCPCS	Description	Services	Beneficiaries	Medicare allowed
99214	Established patient office or other outpatient visit, 30-39 minutes	637	209	$0
99213	Established patient office or other outpatient visit, 20-29 minutes	480	204	$0
36415	Insertion of needle into vein for collection of blood sample	460	226	$0
J1100	Injection, dexamethasone sodium phosphate, 1 mg	128	71	$0
99204	New patient office or other outpatient visit, 45-59 minutes	124	124	$0

View full utilization report →

Insurance plans in this area (ZIP 81052)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
FAMILY MEDICINE	CO	73110	X-ray of wrist, minimum of 3 views	11	11
FAMILY MEDICINE	CO	73630	X-ray of foot, minimum of 3 views	18	17

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: 8527031533View full group profile

Name	Specialty	State
DR. MARGARITE ANNE BECHIS (MD)	Family Practice	CO
MRS. DENISE L. KIDD (LPC)	Mental Health Counselor	CO
LIESL NOEL WYKA (N.P.)	Nurse Practitioner	HI
MS. HEATHER MARIE HOPE COOK (FNP-C)	Nurse Practitioner	WA
DR. JESSE VOTH-GAEDDERT (MD)	Family Practice	KS
OLIVIA GETTMAN	Physician Assistant	CO
MS. LAURA GAY BREWER (PA-C)	Physician Assistant	CO
MARK J VONDERHARR (PA-C)	Physician Assistant	CO
NAOMI R MATA (M.D.)	Family Practice	CO
DR. DAVID ROBERT DAVID (M.D.)	-	CO