Unknown Individual – Family Medicine Physician, NPI 1750309142

Unknown Individual is a healthcare provider. based in Maryville, Missouri. specializing in Family Medicine Physician. They hold a License No. 119789 (MO). The NPI Number for Unknown Individual is 1750309142

Main info

Organization
Inactive
31 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1750309142
Phone
(660) 562-2525
Address
2016 S MAIN ST
Deactivation Date
26 February 2026

Doctor Profile

Medical School Name
KANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
Secondary Phone
5737693753
Graduation Year
1995 (31 years ago)
PAC ID
8729063110
Group Practice PAC ID
5991616138
Professional Enrollment ID
I20040621000827

Contacts

Main Contact
https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Secure Messaging
referrrals_hmc@encompassmed.direct-ci.net
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 2016 S MAIN ST

    MARYVILLE, MO 644682655

    Phone: (660) 562-2525

    Fax: (660) 562-7996

    Type: Mailing

  • 326, Badgerboro Road, Bog Corner, Palmyra, Somerset County, Maine, 04965, United States

    PALMYRA, MO 634613119

    Phone: (573) 769-3710

    Fax: (573) 769-3753

    Type: Mailing

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
99214Established patient office or other outpatient visit, 30-39 minutes189159$0
99213Established patient office or other outpatient visit, 20-29 minutes144123$0
36415Insertion of needle into vein for collection of blood sample7263$0
80053Blood test, comprehensive group of blood chemicals5754$0
85027Complete blood cell count (red cells, white blood cell, platelets), automated test3534$0
View full utilization report →

Insurance plans in this area (ZIP 64468)

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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: 5991616138View full group profile

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1750309142 uniquely identifies Unknown Individual in U.S. healthcare data.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Maryville, Missouri?
If you are local to Maryville, Missouri, Unknown Individual may be relevant to your search.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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