Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1487993895

Unknown Individual is a healthcare provider. based in Magnolia, Kentucky. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 1139569 (KY). The NPI Number for Unknown Individual is 1487993895

Main info

Organization
Inactive
13 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1487993895
Phone
(270) 734-2510
Address
1333 ROUND BEND RD
Deactivation Date
23 November 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5024237246
Graduation Year
2013 (13 years ago)
PAC ID
5294029237
Group Practice PAC ID
4688977218
Professional Enrollment ID
I20160812002183
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:0State licenses:3Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 1333 ROUND BEND RD

    MAGNOLIA, KY 427577937

    Phone: (270) 734-2510

    Type: Mailing

  • 289 IRELAND AVE

    FORT KNOX, KY 401215111

    Phone: (270) 734-2510

    Type: Location

  • 255 Church St

    Pikeville, KY 415013476

    Phone: (270) 291-1459

    Type: Location

  • 2069 SHAKER RUN RD

    LEXINGTON, KY 405098470

    Phone: (270) 291-1459

    Type: Mailing

  • 100 LONDON MOUNTAIN VIEW DR

    LONDON, KY 407416668

    Phone: (270) 291-1459

    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 $18.

Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.

Last reported payment date: 2023-03-10 • Largest payer in this snapshot: EAGLE PHARMACEUTICALS, INC. ($18).

Total Amount

$18

General + Research + Ownership

Payments

1

Total payment records

General Amount

$18

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-03-10

Latest reported date

Top Companies

Largest payers in this snapshot

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 42757)

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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: 4688977218View full group profile
NameSpecialtyState
-FL
Certified Registered Nurse Anesthetist (Crna)KY
-AR
Certified Registered Nurse Anesthetist (Crna)KY
-KY
Certified Registered Nurse Anesthetist (Crna)MS
-KY
-KY
Certified Registered Nurse Anesthetist (Crna)KY
Certified Registered Nurse Anesthetist (Crna)KY

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 1487993895 for Unknown Individual.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Magnolia, Kentucky. Check all listed addresses for suites or satellite offices.
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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