Unknown Individual – Internal Medicine Physician, NPI 1376568725

Unknown Individual is a healthcare provider. based in Cape girardeau, Missouri. specializing in Internal Medicine Physician. They hold a License No. R8J64 (MO). The NPI Number for Unknown Individual is 1376568725

Main info

Organization
Inactive
38 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1376568725
Phone
(573) 335-2900
Address
465 S MOUNT AUBURN RD
Deactivation Date
14 June 2023

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Secondary Phone
5733352900
Graduation Year
1988 (38 years ago)
PAC ID
1254339914
Group Practice PAC ID
8921294257
Professional Enrollment ID
I20061114000173
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • North Mount Auburn Road, Cape Girardeau, Cape Girardeau County, Missouri, 63701, United States

    SUITE 103

    CAPE GIRARDEAU, MO 637034926

    Phone: (573) 335-2900

    Fax: (573) 335-2905

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes218191$0
J0696Injection, ceftriaxone sodium, per 250 mg20854$0
96372Injection of drug or substance under skin or into muscle202140$0
J2930Injection, methylprednisolone sodium succinate, up to 125 mg140133$0
87426Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus7974$0
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Insurance plans in this area (ZIP 63703)

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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: 8921294257View full group profile
NameSpecialtyState
Nurse PractitionerMO
Emergency MedicineMO
Pediatric Medicine, Internal MedicineMO
Nurse PractitionerMO

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 1376568725 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 services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Cape Girardeau, Missouri. 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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