Unknown Individual – Family Medicine Physician, NPI 1558314989
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
102, East 11th Street, Liberal, Seward County, Kansas, 67901, United States
LIBERAL, KS 679012784
Phone: (620) 624-2565
Fax: (620) 624-3016
Type: Mailing
400, Canna Lane, Liberal, Seward County, Kansas, 67901, United States
LIBERAL, KS 679014915
Phone: (620) 624-2565
Fax: (620) 624-3016
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 27 Open Payments records for all available years, with a total value of $489.
Total Amount is formed as General ($489) + Research ($0) + Ownership ($0) = $489.
Last reported payment date: 2024-11-26 • Largest payer in this snapshot: Abbott Laboratories ($213).
Total Amount
$489
General + Research + Ownership
Payments
27
Total payment records
General Amount
$489
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $213 |
| ABBVIE INC. | $54 |
| PFIZER INC. | $49 |
| Novo Nordisk Inc | $43 |
| Lilly USA, LLC | $39 |
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 268 | 157 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 149 | 105 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 38 | 38 | $0 |
| 81002 | Urinalysis, manual test | 30 | 22 | $0 |
| 83036 | Hemoglobin a1c level | 18 | 14 | $0 |
Insurance plans in this area (ZIP 67901)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INTERNAL MEDICINE | KS | 81002 | Urinalysis, manual test | 19 | 16 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | KS |
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