Unknown Individual – Orthopaedic Surgery Physician, NPI 1407804164

Unknown Individual is a healthcare provider. based in London, Kentucky. specializing in Orthopaedic Surgery Physician. They hold a License No. 34030 (KY). The NPI Number for Unknown Individual is 1407804164

Main info

Organization
Inactive
32 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1407804164
Phone
(606) 330-7835
Address
PO BOX 936
Deactivation Date
12 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6068640770
Graduation Year
1994 (32 years ago)
PAC ID
5991774846
Group Practice PAC ID
8820993702
Professional Enrollment ID
I20040928001037
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

  • The Box, 4-6, Ram Place, Homerton, London Borough of Hackney, London, Greater London, England, E9 6LT, United Kingdom

    LONDON, KY 407430936

    Phone: (606) 330-7835

    Fax: (606) 330-7825

    Type: Mailing

  • London Mountain View Drive, London, Laurel County, Kentucky, 40755, United States

    LONDON, KY 407416601

    Phone: (606) 864-0770

    Fax: (606) 864-1461

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $23.

Total Amount is formed as General ($23) + Research ($0) + Ownership ($0) = $23.

Last reported payment date: 2023-03-28 • Largest payer in this snapshot: ABBVIE INC. ($23).

Total Amount

$23

General + Research + Ownership

Payments

1

Total payment records

General Amount

$23

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-03-28

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$23
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
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg20025$0
99213Established patient office or other outpatient visit, 20-29 minutes5744$0
20610Aspiration and/or injection of fluid from large joint4035$0
73560X-ray of knee, 1-2 views2525$0
99203New patient office or other outpatient visit, 30-44 minutes2323$0
View full utilization report →

Insurance plans in this area (ZIP 40743)

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Provider's Procedures

Unknown Individual performs procedures in Orthopaedic Surgery Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ORTHOPEDIC SURGERYKY73562X-ray of knee, 3 views1414
ORTHOPEDIC SURGERYKY20610Aspiration and/or injection of large joint or joint capsule11995

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: 8820993702View full group profile
NameSpecialtyState
Orthopedic SurgeryKY
General SurgeryKY
-KY
-KY
Nurse PractitionerKY
Interventional Cardiology, Cardiovascular Disease (Cardiology)KY
N E U R O L O G YOH
Clinical Social WorkerKY
-KY
Surgical OncologyOH

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1407804164.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to London, Kentucky in the data we show; additional addresses may exist on the full record.
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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