Unknown Individual – Psychiatry Physician, NPI 1699759712

Unknown Individual is a healthcare provider. based in Colorado springs, Colorado. specializing in Psychiatry Physician. They hold a License No. DR.0063943 (CO). The NPI Number for Unknown Individual is 1699759712

Main info

Organization
Inactive
37 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1699759712
Phone
(719) 572-6100
Address
115 S PARKSIDE DR
Deactivation Date
20 December 2020

Doctor Profile

Medical School Name
PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
1989 (37 years ago)
PAC ID
4082683446
Professional Enrollment ID
I20041001000373
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:0State licenses:9Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 115, South Parkside Drive, Colorado Springs, El Paso County, Colorado, 80910, United States

    COLORADO SPRINGS, CO 809103130

    Phone: (719) 572-6100

    Type: Location

  • 216, Willow Wood Drive, Wyndham, New Britain Township, Bucks County, Pennsylvania, 18901, United States

    DOYLESTOWN, PA 189015064

    Phone: (215) 345-5817

    Fax: (215) 345-5817

    Type: Mailing

  • 216 Willow Wood Dr

    Doylestown, PA 189015064

    Phone: (215) 345-5817

    Fax: (215) 345-5817

    Type: Location

  • 7300 147th St W Ste 204

    Apple Valley, MN 551247850

    Phone: (952) 997-3020

    Fax: (952) 997-3026

    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.

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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 80910)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1699759712 is assigned to Unknown Individual under the national enumeration system.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Colorado?
You will see Colorado Springs, Colorado on file for Unknown Individual alongside any extra practice locations.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1699759712. Always confirm identity and privileges with the practice and licensing boards.