Unknown Individual – Psychiatry Physician, NPI 1760462808

Unknown Individual is a healthcare provider. based in Kansas city, Kansas. specializing in Psychiatry Physician. They hold a License No. 04-20488 (KS). The NPI Number for Unknown Individual is 1760462808

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1760462808
Phone
(913) 588-1328
Address
3901 RAINBOW BLVD # MS 4015
Deactivation Date
28 April 2021

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
-
Graduation Year
1978 (48 years ago)
PAC ID
2163458092
Group Practice PAC ID
8921911587
Professional Enrollment ID
I20051028000219
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience27
Completeness75
Years active:0State licenses:3Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 3901 RAINBOW BLVD # MS 4015

    KANSAS CITY, KS 661601960

    Phone: (913) 588-1328

    Fax: (913) 385-2412

    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)

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 66160)

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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: 8921911587View full group profile

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1760462808 as the unique 10-digit identifier.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Kansas City?
Unknown Individual currently maps to Kansas City, Kansas in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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