Unknown Individual – Internal Medicine Physician, NPI 1407878614

Unknown Individual is a healthcare provider. based in Nevada, Missouri. specializing in Internal Medicine Physician. They hold a License No. 32062 (MO). The NPI Number for Unknown Individual is 1407878614

Main info

Organization
Inactive
57 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1407878614
Phone
(417) 684-3949
Address
13999 E NORTHERN RD
Deactivation Date
17 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8163804010
Graduation Year
1969 (57 years ago)
PAC ID
2668444274
Group Practice PAC ID
7618877903
Professional Enrollment ID
I20040812000564
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

  • 13999 E NORTHERN RD

    NEVADA, MO 647728959

    Phone: (417) 684-3949

    Fax: (417) 667-3337

    Type: Mailing

  • 627 W Centennial Ave

    Carthage, MO 648362847

    Phone: (417) 358-8121

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $60.

Total Amount is formed as General ($60) + Research ($0) + Ownership ($0) = $60.

Last reported payment date: 2023-11-15 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($32).

Total Amount

$60

General + Research + Ownership

Payments

3

Total payment records

General Amount

$60

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-15

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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 64772)

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: 7618877903View full group profile
NameSpecialtyState
Clinical PsychologistMO
Mental Health CounselorMO
Mental Health CounselorMO
Nurse PractitionerMO
Clinical Social WorkerMO
Clinical PsychologistMO
Nurse PractitionerMO
-MO

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

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1407878614 for Unknown Individual, then check state licensing separately.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Internal Medicine Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Nevada, Missouri may find Unknown Individual in results; validate coverage separately.
How many locations tie to this NPI?
3 practice locations appear in the available data.

Similar Providers

Nevada Regional Medical Center, 800, South Ash Street, Nevada, Vernon County, Missouri, 64772, United States
NPI: 1992786305

DR. WARREN C JR. LOVINGER (MD)

Internal Medicine Physician
625, South Ash Street, Nevada, Vernon County, Missouri, 64772, United States
NPI: 1427037670

DR. DANIEL E BARNES (MD)

Internal Medicine Physician
Pioneer Road, Nye County, Nevada, United States
NPI: 1477502268

NEVADA INTERNAL MEDICINE, INC

Internal Medicine Physician
625, South Ash Street, Nevada, Vernon County, Missouri, 64772, United States
NPI: 1487603015

Unknown Individual

Pulmonary Disease Physician
Nevada Regional Medical Center, 800, South Ash Street, Nevada, Vernon County, Missouri, 64772, United States
NPI: 1235170952

BARNES MEDICAL CONSULTANTS, LLC

Internal Medicine Physician
RR 6 BOX 110-9
NPI: 1336334952

DR. BRANDON D SOHM (MD)

Internal Medicine Physician
1900 Electric Rd
NPI: 1114242997

GRANT TYLER PIERSON (D.O.)

Pulmonary Disease Physician
800 S Ash St
NPI: 1699034900