Unknown Individual – Neurology Physician, NPI 1124025614

Unknown Individual is a healthcare provider. based in Hopkinsville, Kentucky. specializing in Neurology Physician. They hold a License No. 22624 (KY). The NPI Number for Unknown Individual is 1124025614

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1124025614
Phone
(270) 707-8077
Address
PO BOX 86
Deactivation Date
6 May 2022

Doctor Profile

Medical School Name
TUFTS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1979 (47 years ago)
PAC ID
7113930157
Professional Enrollment ID
I20060717000254
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • PO BOX 86

    HOPKINSVILLE, KY 422410086

    Phone: (270) 707-8077

    Fax: (270) 707-8037

    Type: Mailing

  • 1724 KENTON ST

    SUITE 1A

    HOPKINSVILLE, KY 422401981

    Phone: (270) 707-8077

    Fax: (270) 707-8037

    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.

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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 42241)

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Provider's Procedures

Unknown Individual performs procedures in Neurology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NEUROLOGYKY95819Measurement and recording of brain wave (EEG) activity, awake and asleep2521

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1124025614 — the number used across U.S. healthcare to identify this provider.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Neurology Physician. Clinical services aligned with this taxonomy classification.
Where in Kentucky is Unknown Individual registered?
Use Hopkinsville, Kentucky as the headline location for Unknown Individual here.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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