Unknown Individual – Clinical Psychologist, NPI 1194889907

Unknown Individual is a healthcare provider. based in Bradenton, Florida. specializing in Clinical Psychologist. They hold a License No. PY 6986 (FL). The NPI Number for Unknown Individual is 1194889907

Main info

Organization
Inactive
37 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1194889907
Phone
(941) 448-8528
Address
12505 CARA CARA LOOP
Deactivation Date
6 October 2023

Doctor Profile

Medical School Name
GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
8656931000
Graduation Year
1989 (37 years ago)
PAC ID
4789649088
Group Practice PAC ID
2567729395
Professional Enrollment ID
I20041129000575
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

Provider Addresses for Unknown Individual

  • 12505 CARA CARA LOOP

    BRADENTON, FL 342122949

    Phone: (941) 448-8528

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 34212)

Loading plans...

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: 2567729395View full group profile
NameSpecialtyState
Clinical PsychologistFL
Nurse PractitionerFL
-IL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerKS
Nurse PractitionerFL
-NY
-FL

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1194889907.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Bradenton, Florida in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

Similar Providers

DR. MARY ANN CLARK (PH.D.)

Clinical Psychologist
Riverside Drive East, Manatee, Bradenton, Manatee County, Florida, 34208, United States
NPI: 1174526578

DR. JENNIE LYNNE ROBB (PH.D.)

Clinical Psychologist
9070 58TH DRIVE EAST #102
NPI: 1336131945

DR. DAVID JAMES HOBBS (PHD)

Clinical Psychologist
2110, 58th Street West, Bradenton, Manatee County, Florida, 34209, United States
NPI: 1023003886

DR. JAMES M MCGOVERN (PSY.D.)

Clinical Neuropsychologist
1023 MANATEE AVE W STE 302
NPI: 1811982598
7294 CLOISTER DR APT 7
NPI: 1619906799

DR. RICHARD LEE BELSHAM (PH.D.)

Clinical Psychologist
Passport Health Bradenton Travel Clinic, 5190, 26th Street West, Bradenton, Manatee County, Florida, 34207, United States
NPI: 1750306403
101, 8th Avenue West, Palmetto, Manatee County, Florida, 34221, United States
NPI: 1750305587
272 FAIRWAY ISLES LN
NPI: 1811903917

DR. MARK IRA BORNSTEIN (PSYD)

Clinical Psychologist
46, Cumberland Drive, Lincolnshire, Lake County, Illinois, 60069, United States
NPI: 1518078351