Unknown Individual – Obstetrics & Gynecology Physician, NPI 1578541595

Unknown Individual is a healthcare provider. based in Springfield, Missouri. specializing in Obstetrics & Gynecology Physician. They hold a License No. 2018030294 (MO). The NPI Number for Unknown Individual is 1578541595

Main info

Organization
Inactive
36 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1578541595
Phone
(417) 820-3559
Address
1965 S FREMONT AVE STE 270
Deactivation Date
18 August 2021

Doctor Profile

Medical School Name
UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Secondary Phone
4178203890
Graduation Year
1990 (36 years ago)
PAC ID
2567405830
Group Practice PAC ID
7416865845
Professional Enrollment ID
I20180829000147
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 270, South Fremont Avenue, Rountree/Walnut, Springfield, Greene County, Missouri, 65802, United States

    SPRINGFIELD, MO 658042257

    Phone: (417) 820-3559

    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 65804)

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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: 7416865845View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1578541595 — is the standard way to identify this listing.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Springfield, Missouri; more addresses can appear in NPPES.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."