Unknown Individual – Internal Medicine Physician, NPI 1427024256

Unknown Individual is a healthcare provider. based in Lakeland, Florida. specializing in Internal Medicine Physician. They hold a License No. OS7665 (FL). The NPI Number for Unknown Individual is 1427024256

Main info

Organization
Inactive
32 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1427024256
Phone
(863) 680-7000
Address
1600 LAKELAND HILLS BLVD
Deactivation Date
25 October 2023

Doctor Profile

Medical School Name
DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Secondary Phone
8137192500
Graduation Year
1994 (32 years ago)
PAC ID
8426023631
Group Practice PAC ID
1456258979
Professional Enrollment ID
I20100209000625

Contacts

Secure Messaging
ckelly6614@direct.watsonclinicad.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • 1600, Lakeland Hills Boulevard, Lakeland, Polk County, Florida, 33805, United States

    LAKELAND, FL 338053019

    Phone: (863) 680-7000

    Fax: (866) 264-8519

    Type: Mailing

  • East Alexander Street, Plant City, Hillsborough County, Florida, 33566, United States

    PLANT CITY, FL 335637126

    Phone: (813) 719-2500

    Fax: (866) 264-8519

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 14 Open Payments records for all available years, with a total value of $259.

Total Amount is formed as General ($259) + Research ($0) + Ownership ($0) = $259.

Last reported payment date: 2023-06-14 • Largest payer in this snapshot: Lilly USA, LLC ($82).

Total Amount

$259

General + Research + Ownership

Payments

14

Total payment records

General Amount

$259

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-06-14

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes11091$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit3333$0
93000Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report1616$0
View full utilization report →

Insurance plans in this area (ZIP 33805)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEFL90670Pneumococcal vaccine for injection into muscle2121

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: 1456258979View full group profile
NameSpecialtyState
Internal MedicineFL
A N E S T H E S I O L O G YFL
-FL
Physical Therapist In Private PracticeFL
Pulmonary Disease, Internal MedicineFL
-FL
Nurse PractitionerFL
Emergency MedicineFL
-FL
Nurse PractitionerFL

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1427024256.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Lakeland, Florida in the same public data insurers reference.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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