Unknown Individual – Family Medicine Physician, NPI 1740347863

Unknown Individual is a healthcare provider. based in Burkesville, Kentucky. specializing in Family Medicine Physician. They hold a License No. 18176 (KY). The NPI Number for Unknown Individual is 1740347863

Main info

Organization
Inactive
52 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1740347863
Phone
(270) 864-1472
Address
PO BOX 1080
Deactivation Date
30 January 2025

Doctor Profile

Medical School Name
UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
Secondary Phone
6063765391
Graduation Year
1974 (52 years ago)
PAC ID
0244204550
Group Practice PAC ID
6305947789
Professional Enrollment ID
I20100630000818
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

Provider Addresses for Unknown Individual

  • PO BOX 1080

    BURKESVILLE, KY 427171080

    Phone: (270) 864-1472

    Fax: (270) 864-1693

    Type: Mailing

  • 19 MEDICAL LOOP

    SUITE #3

    WHITLEY CITY, KY 426534382

    Phone: (606) 376-5391

    Fax: (606) 376-3326

    Type: Location

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.

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

Insurance plans in this area (ZIP 42717)

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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: 6305947789View full group profile
NameSpecialtyState
Nurse PractitionerKY
Nurse PractitionerKY
Certified Nurse Midwife (Cnm)KY
Clinical Social WorkerKY
Nurse PractitionerKY
Nurse PractitionerKY
Nurse PractitionerKY
O B S T E T R I C S/ G Y N E C O L O G YKY
Certified Nurse Midwife (Cnm)KY
Nurse PractitionerKY

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1740347863.
Does inactive mean outdated data 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 Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Burkesville, Kentucky in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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