Unknown Individual – Pain Medicine (Anesthesiology) Physician, NPI 1427043124

Unknown Individual is a healthcare provider. based in Jefferson city, Missouri. specializing in Pain Medicine (Anesthesiology) Physician. They hold a License No. 101277 (MO). The NPI Number for Unknown Individual is 1427043124

Main info

Organization
Inactive
39 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1427043124
Phone
(573) 636-3483
Address
1445 CHRISTY DR
Deactivation Date
30 October 2025

Doctor Profile

Medical School Name
AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Secondary Phone
5736357022
Graduation Year
1987 (39 years ago)
PAC ID
9739104381
Group Practice PAC ID
8224025747
Professional Enrollment ID
I20051012000665
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

  • 1445, Christy Drive, Jefferson City, Cole County, Missouri, 65101, United States

    JEFFERSON CITY, MO 651012853

    Phone: (573) 636-3483

    Fax: (573) 636-5315

    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
00142Anesthesia for lens surgery295268$0
00140Anesthesia for other procedure on eye2121$0
00103Anesthesia for procedure on eyelid1919$0
View full utilization report →

Insurance plans in this area (ZIP 65101)

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Provider's Procedures

Unknown Individual performs procedures in Pain Medicine (Anesthesiology) Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ANESTHESIOLOGYMO76942Ultrasonic guidance imaging supervision and interpretation for insertion of needle1717

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: 8224025747View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MO
A N E S T H E S I O L O G YMO
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)MO
-MO
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)MO
Critical Care (Intensivists), AnesthesiologyMO
Certified Registered Nurse Anesthetist (Crna)MO

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1427043124 for Unknown Individual, then check state licensing separately.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Pain Medicine (Anesthesiology) Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Jefferson City, Missouri as a primary anchor for Unknown Individual unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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