Unknown Individual – Diagnostic Radiology Physician, NPI 1316967417

Unknown Individual is a healthcare provider. based in Overland park, Kansas. specializing in Diagnostic Radiology Physician. They hold a License No. R5230 (MO). The NPI Number for Unknown Individual is 1316967417

Main info

Organization
Inactive
54 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1316967417
Phone
(913) 599-6777
Address
9212 NIEMAN RD
Deactivation Date
31 July 2024

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Secondary Phone
6607851000
Graduation Year
1972 (54 years ago)
PAC ID
7315936085
Group Practice PAC ID
6800870593
Professional Enrollment ID
I20040507001175
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

  • Nieman Road, Overland Park, Johnson County, Kansas, 66210, United States

    OVERLAND PARK, KS 662141868

    Phone: (913) 599-6777

    Fax: (913) 599-3955

    Type: Mailing

  • Liberty Hospital, 2525, Glenn Hendren Drive, Liberty, Clay County, Missouri, 64068, United States

    LIBERTY, MO 640689625

    Phone: (816) 407-2038

    Fax: (816) 792-7135

    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 66214)

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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 RADIOLOGYMO71010X-ray of chest, 1 view, front554408
DIAGNOSTIC RADIOLOGYMO73562X-ray of knee, 3 views6852
DIAGNOSTIC RADIOLOGYMO74177CT scan of abdomen and pelvis with contrast124118

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: 6800870593View full group profile
NameSpecialtyState
DR. ALAN E HILLARD (MD)
-MO
DR. MARK H MONROE (M.D.)
Diagnostic RadiologyMO
JONAS SINGER (M.D.)
-MO

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1316967417.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Diagnostic Radiology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Overland Park, Kansas in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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