Unknown Individual – Diagnostic Radiology Physician, NPI 1184620973

Unknown Individual is a healthcare provider. based in Iowa city, Iowa. specializing in Diagnostic Radiology Physician. They hold a License No. 17120 (IA). The NPI Number for Unknown Individual is 1184620973

Main info

Organization
Inactive
62 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1184620973
Phone
(319) 353-6992
Address
200 Hawkins Dr
Deactivation Date
13 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3193561616
Graduation Year
1964 (62 years ago)
PAC ID
3274583612
Group Practice PAC ID
7618884230
Professional Enrollment ID
I20050124001078
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

  • 200 Hawkins Dr

    Iowa City, IA 52242

    Phone: (319) 353-6992

    Type: Location

  • 105 E 9th St

    Coralville, IA 522412209

    Phone: (319) 467-2000

    Fax: (319) 467-2410

    Type: Location

  • University of Iowa Hospitals & Clinics, 200, Hawkins Drive, Iowa City, Johnson County, Iowa, 52245, United States

    IOWA CITY, IA 522421009

    Phone: (319) 353-6992

    Type: Mailing

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 52242)

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Provider's Procedures

Unknown Individual performs procedures in Diagnostic Radiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYIA71010X-ray of chest, 1 view, front6050
DIAGNOSTIC RADIOLOGYIA73630X-ray of foot, minimum of 3 views1514

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: 7618884230View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1184620973 is assigned to Unknown Individual under the national enumeration system.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Iowa?
You will see Iowa City, Iowa on file for Unknown Individual alongside any extra practice locations.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1184620973. Always confirm identity and privileges with the practice and licensing boards.

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