Unknown Individual – Rheumatology Physician, NPI 1376540674

Rheumatology Physician

Unknown Individual is a healthcare provider. based in Joplin, Missouri. specializing in Rheumatology Physician. They hold a License No. R8B94 (MO). The NPI Number for Unknown Individual is 1376540674

Main info

Organization

Inactive

57 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1376540674

Phone

(417) 623-2600

Address

1505 WEST 10TH ST.

Deactivation Date

13 March 2024

Doctor Profile

Medical School Name

OTHER

Secondary Phone

4176232600

Graduation Year

1969 (57 years ago)

PAC ID

0244250504

Professional Enrollment ID

I20051201000132

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

1505, West 10th Street, Joplin, Jasper County, Missouri, 64801, United States
SUITE C
JOPLIN, MO 64801
Phone: (417) 623-2600
Fax: (417) 623-1974
Type: Mailing
East 10th Street, East Joplin, Joplin, Jasper County, Missouri, 64802, United States
SUITE C
JOPLIN, MO 64801
Phone: (417) 623-2600
Fax: (417) 623-1974
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.

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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 64801)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?

NPI numbers are unique to each provider or organization — Unknown Individual uses 1376540674.

Why might Unknown Individual appear inactive while still practicing?

We display what the registry publishes: Unknown Individual appears inactive there.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Rheumatology Physician in this dataset. Clinical services aligned with this taxonomy classification.

Does Unknown Individual list a practice location?

Patients near Joplin, Missouri may find Unknown Individual in results; validate coverage separately.

Why does Unknown Individual have multiple addresses?

2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.