Unknown Individual – Internal Medicine Physician, NPI 1972575587

Unknown Individual is a healthcare provider. based in Liberal, Kansas. specializing in Internal Medicine Physician. They hold a License No. 34051 (SC). The NPI Number for Unknown Individual is 1972575587

Main info

Organization
Inactive
39 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1972575587
Phone
(620) 629-6638
Address
PO BOX 1215
Deactivation Date
28 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6206296727
Graduation Year
1987 (39 years ago)
PAC ID
3971525809
Group Practice PAC ID
5395732820
Professional Enrollment ID
I20140517000152
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:0State licenses:4Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Liberal Arts Education Centre, Jalan Masjid, Kembangan, Bedok, East Region, Singapore, 416825, Singapore

    ATTN CLINIC BILLING OFFICE

    LIBERAL, KS 679051215

    Phone: (620) 629-6638

    Fax: (620) 629-6684

    Type: Mailing

  • SouthWest Medical Center, 315, West 15th Street, Liberal, Seward County, Kansas, 67901, United States

    LIBERAL, KS 679012455

    Phone: (620) 629-6477

    Fax: (620) 629-6651

    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 67905)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEKS36556Insertion of central venous catheter for infusion, patient 5 years or older5149
INTERNAL MEDICINEKS93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report637283

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: 5395732820View full group profile
NameSpecialtyState
JAMES JOSEPH DOYLE (MD)
Internal MedicineTX
DENNIS F JR. MOORE (MD)
H E M A T O L O G Y/ O N C O L O G YKS
IMAD I NASSIF (MD)
G A S T R O E N T E R O L O G YKS
BASSAM I MATTAR (MD)
H E M A T O L O G Y/ O N C O L O G YKS
BRADLEY HUNTER BARRETT (M.D.)
Family PracticeKS
DR. BERT CHRONISTER (M.D.)
-KS
TIMOTHY B WIENS (MD)
-KS
KRISTA THURBER (APRN)
-KS
ANGELA LE (APRN)
Nurse PractitionerKS
KAITLEN JOAN HORNBECK (APRN-C)
Nurse PractitionerKS

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1972575587.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Liberal, Kansas in the same public data insurers reference.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.