Unknown Individual – Psychiatry Physician, NPI 1487655775

Unknown Individual is a healthcare provider. based in Bowling green, Kentucky. specializing in Psychiatry Physician. They hold a License No. 34839 (KY). The NPI Number for Unknown Individual is 1487655775

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1487655775
Phone
(270) 843-5103
Address
350 PARK ST
Deactivation Date
5 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2708435103
Graduation Year
1986 (40 years ago)
PAC ID
2365634169
Group Practice PAC ID
7719899947
Professional Enrollment ID
I20101012001057
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Medical Arts Building, 350, Park Street, Bowling Green, Warren County, Kentucky, 42101, United States

    SUITE 204

    BOWLING GREEN, KY 421011784

    Phone: (270) 843-5103

    Fax: (270) 843-5104

    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 8 Open Payments records for all available years, with a total value of $209.

Total Amount is formed as General ($209) + Research ($0) + Ownership ($0) = $209.

Last reported payment date: 2024-03-12 • Largest payer in this snapshot: Inspire Medical Systems, Inc. ($99).

Total Amount

$209

General + Research + Ownership

Payments

8

Total payment records

General Amount

$209

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-12

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
99214Established patient office or other outpatient visit, 30-39 minutes20167$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes6833$0
99213Established patient office or other outpatient visit, 20-29 minutes5439$0
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes3514$0
95810Sleep study in sleep lab (6 years or older)1818$0
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Insurance plans in this area (ZIP 42101)

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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
PSYCHIATRYKY90792Psychiatric diagnostic evaluation with medical services1313

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: 7719899947View full group profile
NameSpecialtyState
Vascular Surgery, General SurgeryKY
Interventional Radiology, Diagnostic RadiologyKY
N E U R O L O G YKY
-KY
Nurse PractitionerKY
Registered Dietitian Or Nutrition ProfessionalKY
General SurgeryTN
Diagnostic Radiology, Interventional RadiologyIN
P S Y C H I A T R YKY
Nurse PractitionerKY

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1487655775 as the unique 10-digit identifier.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Psychiatry Physician in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Bowling Green, Kentucky as the reference point for Unknown Individual, then confirm.
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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