Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1639138712

Unknown Individual is a healthcare provider. based in Bowling green, Kentucky. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 106968 (TN). The NPI Number for Unknown Individual is 1639138712

Main info

Organization
Inactive
29 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1639138712
Phone
(270) 393-1912
Address
350 PARK ST
Deactivation Date
8 April 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2707374600
Graduation Year
1997 (29 years ago)
PAC ID
1355242629
Group Practice PAC ID
8729051479
Professional Enrollment ID
I20061017000438
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

Loading map...

Provider Addresses for Unknown Individual

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

    STE 203 B

    BOWLING GREEN, KY 421011784

    Phone: (270) 393-1912

    Fax: (270) 393-1913

    Type: Mailing

  • The Medical Center at Bowling Green, 250, Park Street, Bowling Green, Warren County, Kentucky, 42101, United States

    BOWLING GREEN, KY 421011760

    Phone: (270) 745-1000

    Fax: (270) 393-1913

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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.

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

Insurance plans in this area (ZIP 42101)

Loading plans...

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: 8729051479View full group profile

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1639138712.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Bowling Green, Kentucky.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

Similar Providers

PLJ ANESTHESIA ASSOCIATES LLC

Certified Registered Nurse Anesthetist
PO BOX 50850
NPI: 1861485674
825 2ND AVE
NPI: 1548253107

VICKI ANN MEREDITH (CRNA)

Certified Registered Nurse Anesthetist
Medical Arts Building, 350, Park Street, Bowling Green, Warren County, Kentucky, 42101, United States
NPI: 1568456762

LEEANNE BROWN (CRNA)

Certified Registered Nurse Anesthetist
The Medical Center at Bowling Green, 250, Park Street, Bowling Green, Warren County, Kentucky, 42101, United States
NPI: 1225022304

BARRY KEITH MONROE (CRNA)

Certified Registered Nurse Anesthetist
Graves Gilbert Clinic, 350, Park Street, Bowling Green, Warren County, Kentucky, 42101, United States
NPI: 1639163348

ROBERT KEITH NORMAN (CRNA)

Certified Registered Nurse Anesthetist
The Medical Center at Bowling Green, 250, Park Street, Bowling Green, Warren County, Kentucky, 42101, United States
NPI: 1508850223

MR. TODD BRIAN OLLER (CRNA)

Certified Registered Nurse Anesthetist
Rvierside Professional Building, 825, East 2nd Avenue, Bowling Green, Warren County, Kentucky, 42101, United States
NPI: 1376537092

SHERRI L HERMAN (CRNA)

Certified Registered Nurse Anesthetist
The Medical Center at Bowling Green, 250, Park Street, Bowling Green, Warren County, Kentucky, 42101, United States
NPI: 1487648127

JONATHAN S DICKINSON (CRNA)

Certified Registered Nurse Anesthetist
Graves Gilbert Clinic, 350, Park Street, Bowling Green, Warren County, Kentucky, 42101, United States
NPI: 1821082579