Unknown Individual – Neurology Physician, NPI 1700836962

Unknown Individual is a healthcare provider. based in Rolla, Missouri. specializing in Neurology Physician. They hold a License No. 2003028757 (MO). The NPI Number for Unknown Individual is 1700836962

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1700836962
Phone
(573) 458-8899
Address
1000 W 10th St
Deactivation Date
29 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1981 (45 years ago)
PAC ID
5890759492
Professional Enrollment ID
I20041115000018
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 1000 W 10th St

    Rolla, MO 654012905

    Phone: (573) 458-8899

    Fax: (573) 341-5611

    Type: Location

  • West 6th Street, Rolla, Phelps County, Missouri, 65409, United States

    ROLLA, MO 654012941

    Phone: (573) 341-8500

    Fax: (573) 341-8581

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 36 Open Payments records for all available years, with a total value of $1,136.

Total Amount is formed as General ($1,136) + Research ($0) + Ownership ($0) = $1,136.

Last reported payment date: 2024-11-14 • Largest payer in this snapshot: SK Life Science, Inc. ($222).

Total Amount

$1,136

General + Research + Ownership

Payments

36

Total payment records

General Amount

$1,136

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-14

Latest reported date

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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes24668$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes12751$0
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes7321$0
95819Measurement of brain wave activity (eeg), awake and asleep5553$0
99214Established patient office or other outpatient visit, 30-39 minutes3630$0
View full utilization report →

Insurance plans in this area (ZIP 65401)

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Provider's Procedures

Unknown Individual performs procedures in Neurology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NEUROLOGYMO95819Measurement and recording of brain wave (EEG) activity, awake and asleep5352

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1700836962.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Neurology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Rolla, Missouri in registry-derived data.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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