Unknown Individual – Cardiovascular Disease Physician, NPI 1184681322

Unknown Individual is a healthcare provider. based in Chesterfield, Missouri. specializing in Cardiovascular Disease Physician. They hold a License No. R5206 (MO). The NPI Number for Unknown Individual is 1184681322

Main info

Organization
Inactive
56 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1184681322
Phone
(314) 205-6969
Address
222 S WOODS MILL RD
Deactivation Date
13 January 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1970 (56 years ago)
PAC ID
5294769501
Professional Enrollment ID
I20050926000257
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

  • 222, South Woods Mill Road, Chesterfield, Saint Louis County, Missouri, 63017, United States

    SUITE 500

    CHESTERFIELD, MO 630173625

    Phone: (314) 205-6969

    Fax: (314) 576-2393

    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.

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

Insurance plans in this area (ZIP 63017)

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Provider's Procedures

Unknown Individual performs procedures in Cardiovascular Disease Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)MO93458Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart7974

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1184681322 in the public NPI dataset.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Chesterfield, Missouri may find Unknown Individual in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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