Unknown Individual – Diagnostic Radiology Physician, NPI 1407823461

Unknown Individual is a healthcare provider. based in Overland park, Kansas. specializing in Diagnostic Radiology Physician. They hold a License No. 04-31155 (KS). The NPI Number for Unknown Individual is 1407823461

Main info

Organization
Inactive
34 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1407823461
Phone
(913) 599-6777
Address
8000 W 110TH ST STE 150
Deactivation Date
18 September 2024

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
Secondary Phone
9133939729
Graduation Year
1992 (34 years ago)
PAC ID
6800838418
Group Practice PAC ID
0042645947
Professional Enrollment ID
I20050524000990
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • West 110th Street, Overland Park, Johnson County, Kansas, 66211-1508, United States

    OVERLAND PARK, KS 662102382

    Phone: (913) 599-6777

    Fax: (913) 599-3955

    Type: Mailing

  • Saint Luke's South Hospital, 12300, Metcalf Avenue, Overland Park, Johnson County, Kansas, 66213, United States

    OVERLAND PARK, KS 662131324

    Phone: (913) 317-7678

    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 66210)

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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: 0042645947View full group profile
NameSpecialtyState
BRADFORD PRICE OLIVA (MD)
Diagnostic RadiologyIA
DR. CHAD M RUBLE (M.D.)
Diagnostic RadiologyKS
MICHAEL W DENNIS (MD)
Diagnostic RadiologyKS
CHARLES W HORNER (MD)
Diagnostic RadiologyKS
DEVAMURUGAN CHANDRAMOHAN (MD)
Diagnostic RadiologyKS
STACEY JESSER
Diagnostic RadiologyVA
CAROLINE EISENHART
Nurse PractitionerKS
DR. MATTHEW SHADE TOWSLEY (M.D.)
Interventional RadiologyMO
LISA H HUTCHISON (M.D.)
Pediatric Medicine, Diagnostic RadiologyMO
SARAH KURIAN
Diagnostic RadiologyIN

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1407823461?
NPI 1407823461 belongs to Unknown Individual; compare other details if you need extra assurance.
Who updates status for Unknown Individual?
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 Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Overland Park?
Public fields place Unknown Individual around Overland Park, Kansas. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.