Unknown Individual – Family Medicine Physician, NPI 1710957253

Unknown Individual is a healthcare provider. based in Kansas city, Missouri. specializing in Family Medicine Physician. They hold a License No. MDR6G43 (MO). The NPI Number for Unknown Individual is 1710957253

Main info

Organization
Inactive
42 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1710957253
Phone
(816) 436-7072
Address
9411 N OAK TRFY
Deactivation Date
11 March 2022

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Secondary Phone
8164361800
Graduation Year
1984 (42 years ago)
PAC ID
4486783834
Group Practice PAC ID
8426081613
Professional Enrollment ID
I20100525000034
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

  • Meritas Health Gashland, 9411, North Oak Trafficway, Kansas City, Clay County, Missouri, 64155, United States

    SUITE LL1

    KANSAS CITY, MO 641552262

    Phone: (816) 436-7072

    Fax: (816) 436-2743

    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 64155)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEMO82270Stool analysis for blood to screen for colon tumors7373
FAMILY MEDICINEMO83036Hemoglobin A1C level187173
FAMILY MEDICINEMO85610Blood test, clotting time17530
FAMILY MEDICINEMO90670Pneumococcal vaccine for injection into muscle150150

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: 8426081613View full group profile
NameSpecialtyState
-MO

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1710957253 on file in the registry.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Kansas City, Missouri as the reference point for Unknown Individual, then confirm.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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