Unknown Individual – Psychiatry Physician, NPI 1275582637

Unknown Individual is a healthcare provider. based in Newton, Kansas. specializing in Psychiatry Physician. They hold a License No. 04-31500 (KS). The NPI Number for Unknown Individual is 1275582637

Main info

Organization
Inactive
38 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1275582637
Phone
(316) 284-6400
Address
1901 E 1ST ST
Deactivation Date
11 May 2022

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
3162846400
Graduation Year
1988 (38 years ago)
PAC ID
2466502869
Group Practice PAC ID
5496652471
Professional Enrollment ID
I20090605000117
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

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Provider Addresses for Unknown Individual

  • East 1st Street, Newton, Catawba County, North Carolina, 28658, United States

    PO BOX 467

    NEWTON, KS 671145010

    Phone: (316) 284-6400

    Fax: (316) 284-6490

    Type: Mailing

  • 9333, East 21st Street North, Minneha, Wichita, Sedgwick County, Kansas, 67206, United States

    WICHITA, KS 672062927

    Phone: (316) 634-4700

    Fax: (316) 634-4770

    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.

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 67114)

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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: 5496652471View full group profile
NameSpecialtyState
Clinical Social WorkerKS
Clinical Social WorkerKS
Nurse PractitionerKS
P S Y C H I A T R YKS
-KS
-KS
Clinical PsychologistKS
Clinical Social WorkerKS
Physician AssistantKS
Marriage And Family TherapistKS

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1275582637 in the public NPI dataset.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Newton, Kansas may find Unknown Individual in results; validate coverage separately.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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