Unknown Individual – Ophthalmology Physician, NPI 1235136409

Unknown Individual is a healthcare provider. based in Lexington, Kentucky. specializing in Ophthalmology Physician. They hold a License No. 24824 (KY). The NPI Number for Unknown Individual is 1235136409

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1235136409
Phone
(859) 277-2692
Address
1401 HARRODSBURG RD
Deactivation Date
21 November 2022

Doctor Profile

Medical School Name
JC EDWARDS SCHOOL OF MEDICINE, MARSHALL UNIVERSITY
Secondary Phone
-
Graduation Year
1982 (44 years ago)
PAC ID
1658416714
Professional Enrollment ID
I20100302000051
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

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Provider Addresses for Unknown Individual

  • Harrodsburg Road, Harrods Park Townhouse, Garden Springs, Lexington, Fayette County, Kentucky, 40390:40513, United States

    SUITE B290

    LEXINGTON, KY 405043751

    Phone: (859) 277-2692

    Fax: (859) 277-9275

    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.

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 40504)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1235136409 for Unknown Individual, then check state licensing separately.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Lexington, Kentucky; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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