Unknown Individual – General Practice Physician, NPI 1376535062

Unknown Individual is a healthcare provider. based in Dodge city, Kansas. specializing in General Practice Physician. They hold a License No. 4-22287 (KS). The NPI Number for Unknown Individual is 1376535062

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1376535062
Phone
(620) 408-9700
Address
2200 SUMMERLON CIR STE A
Deactivation Date
23 December 2020

Doctor Profile

Medical School Name
UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
1976 (50 years ago)
PAC ID
6103729801
Professional Enrollment ID
I20050412001045
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

  • 2200 SUMMERLON CIR STE A

    DODGE CITY, KS 678012905

    Phone: (620) 408-9700

    Fax: (620) 408-9701

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $16.

Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.

Last reported payment date: 2024-06-14 • Largest payer in this snapshot: IDORSIA PHARMACEUTICALS US INC ($16).

Total Amount

$16

General + Research + Ownership

Payments

1

Total payment records

General Amount

$16

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-14

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.

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

Insurance plans in this area (ZIP 67801)

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Provider's Procedures

Unknown Individual performs procedures in General Practice Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
GENERAL PRACTICEKS81002Urinalysis, manual test1413

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1376535062?
NPI 1376535062 belongs to Unknown Individual; compare other details if you need extra assurance.
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 clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to General Practice Physician. Clinical services aligned with this taxonomy classification.
Where in Kansas is Unknown Individual registered?
Use Dodge City, 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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