Unknown Individual – Psychiatry Physician, NPI 1396727079

Unknown Individual is a healthcare provider. based in Lexington, Kentucky. specializing in Psychiatry Physician. They hold a License No. 22423 (KY). The NPI Number for Unknown Individual is 1396727079

Main info

Organization
Inactive
47 Years Of Experience
Name
Unknown Individual
NPI
1396727079
Phone
(859) 223-6700
Address
3121 WALL ST
Deactivation Date
6 February 2025

Doctor Profile

Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Secondary Phone
-
Graduation Year
1979 (47 years ago)
PAC ID
2062400674
Professional Enrollment ID
I20101115001426
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

  • 3121, Wall Street, Lexington, Fayette County, Kentucky, 40513, United States

    LEXINGTON, KY 405131711

    Phone: (859) 223-6700

    Fax: (859) 223-5202

    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)

CMS reports 20 Open Payments records for all available years, with a total value of $238.

Total Amount is formed as General ($238) + Research ($0) + Ownership ($0) = $238.

Last reported payment date: 2024-10-29 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($131).

Total Amount

$238

General + Research + Ownership

Payments

20

Total payment records

General Amount

$238

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-29

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes260103$0
90833Psychotherapy with evaluation and management visit, 30 minutes18873$0
View full utilization report →

Insurance plans in this area (ZIP 40513)

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Provider's Procedures

Unknown Individual performs procedures in Psychiatry Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PSYCHIATRYKY90833Psychotherapy, 30 minutes with patient and/or family member24989

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1396727079 is assigned to Unknown Individual under the national enumeration system.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Lexington, Kentucky for Unknown Individual based on available NPPES addresses.
What if Lexington, Kentucky seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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