Unknown Individual – Physical Therapist, NPI 1457332009

Unknown Individual is a healthcare provider. based in Paducah, Kentucky. specializing in Physical Therapist. They hold a License No. PT001462 (KY). The NPI Number for Unknown Individual is 1457332009

Main info

Organization
Inactive
39 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1457332009
Phone
(270) 442-4396
Address
220 BERGER RD
Deactivation Date
28 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2704430681
Graduation Year
1987 (39 years ago)
PAC ID
3375648124
Group Practice PAC ID
0941523245
Professional Enrollment ID
I20070424000035
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

  • 220, Berger Road, Forest Hill, Paducah, McCracken County, Kentucky, 42003, United States

    PADUCAH, KY 420034522

    Phone: (270) 442-4396

    Fax: (270) 442-3346

    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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities1,309197$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes843174$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes802147$0
97140Therapy procedure using manual technique, each 15 minutes25175$0
97535Training for self-care or home management, each 15 minutes12895$0
View full utilization report →

Insurance plans in this area (ZIP 42003)

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Provider's Procedures

Unknown Individual performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYKY97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes45342

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: 0941523245View full group profile
NameSpecialtyState
-KY
-TN
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeKY
Physical Therapist In Private PracticeKY
-PA
-KY
Physical Therapist In Private PracticeGA
-KY
-IL

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1457332009 for Unknown Individual.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Physical Therapist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Paducah, Kentucky in the same public data insurers reference.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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