Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1023002797

Unknown Individual is a healthcare provider. based in Louisville, Kentucky. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 1046380 (KY). The NPI Number for Unknown Individual is 1023002797

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1023002797
Phone
(502) 473-2132
Address
PO BOX 70354
Deactivation Date
20 September 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2708255100
Graduation Year
1986 (40 years ago)
PAC ID
9032109962
Group Practice PAC ID
7113816174
Professional Enrollment ID
I20040513000950
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

  • PO BOX 70354

    LOUISVILLE, KY 402700354

    Phone: (502) 473-2132

    Fax: (502) 459-0923

    Type: Mailing

  • Baptist Health Louisville, 4000, Kresge Way, Springlee, Louisville, Jefferson County, Kentucky, 40207, United States

    LOUISVILLE, KY 402074605

    Phone: (502) 473-2132

    Fax: (502) 459-0923

    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 40270)

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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: 7113816174View full group profile
NameSpecialtyState
-KY
-KY
-KY
A N E S T H E S I O L O G YKY
A N E S T H E S I O L O G YKY
-KY
A N E S T H E S I O L O G YGA
A N E S T H E S I O L O G YKY
A N E S T H E S I O L O G YKY
-KY

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1023002797 in the public NPI dataset.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Certified Registered Nurse Anesthetist in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Louisville, Kentucky in our summary view.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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