Unknown Individual – Child & Adolescent Psychiatry Physician, NPI 1285664169

Unknown Individual is a healthcare provider. based in Newton, Kansas. specializing in Child & Adolescent Psychiatry Physician. They hold a License No. ND 6439 (ND). The NPI Number for Unknown Individual is 1285664169

Main info

Organization
Inactive
39 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1285664169
Phone
(316) 284-6400
Address
1901 E 1ST ST; PO BOX 467
Deactivation Date
14 August 2024

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
7012343100
Graduation Year
1987 (39 years ago)
PAC ID
1456447333
Group Practice PAC ID
8426967803
Professional Enrollment ID
I20071024000121
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:0State licenses:3Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1901 E 1ST ST; PO BOX 467

    NEWTON, KS 671140467

    Phone: (316) 284-6400

    Fax: (316) 284-6490

    Type: Mailing

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

    NEWTON, KS 671140467

    Phone: (316) 284-6400

    Fax: (316) 284-6490

    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.

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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: 8426967803View full group profile

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1285664169 as the unique 10-digit identifier.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Child & Adolescent Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Where in Kansas is Unknown Individual registered?
Use Newton, Kansas as the headline location for Unknown Individual here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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