Unknown Individual – Family Medicine Physician, NPI 1023084290
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
6520 FORT CAROLINE RD
JACKSONVILLE, FL 322772044
Phone: (904) 745-3618
Fax: (904) 722-4271
Type: Mailing
6484 FORT CAROLINE RD
JACKSONVILLE, FL 322772042
Phone: (904) 744-7300
Fax: (904) 722-4271
Type: Location
Pike County Memorial Hospital, 2305, Georgia Street, Elmwood, Louisiana, Pike County, Missouri, 63353, United States
LOUISIANA, MO 633532559
Phone: (573) 754-4584
Fax: (573) 754-5280
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $136.
Total Amount is formed as General ($136) + Research ($0) + Ownership ($0) = $136.
Last reported payment date: 2023-04-05 • Largest payer in this snapshot: Novo Nordisk Inc ($33).
Total Amount
$136
General + Research + Ownership
Payments
8
Total payment records
General Amount
$136
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-04-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $33 |
| Lundbeck LLC | $22 |
| GlaxoSmithKline, LLC. | $19 |
| Merck Sharp & Dohme LLC | $17 |
| Amgen Inc. | $16 |
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 | 380 | 278 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 212 | 194 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 78 | 70 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 68 | 68 | $0 |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | 37 | 37 | $0 |
Insurance plans in this area (ZIP 32277)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | MO | 11042 | Removal of skin and tissue first 20 sq cm or less | 148 | 26 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O L O G Y | IL | |
| G A S T R O E N T E R O L O G Y | MA | |
| Family Practice | MO | |
| R H E U M A T O L O G Y | IL | |
| U R O L O G Y | IL | |
| Pain Management, Anesthesiology, Anesthesiology, Pain Management | MO | |
| Nurse Practitioner | MI | |
| Orthopedic Surgery | MO | |
| P O D I A T R Y | IL | |
| Clinical Social Worker | MO |
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