Unknown Individual – Vision Therapy Optometrist, NPI 1770508889

Unknown Individual is a healthcare provider. based in Joplin, Missouri. specializing in Vision Therapy Optometrist. They hold a License No. T02322 (MO). The NPI Number for Unknown Individual is 1770508889

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1770508889
Phone
(417) 782-3488
Address
1030 SE MURPHY BLVD
Deactivation Date
18 September 2025

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
4177823488
Graduation Year
1977 (49 years ago)
PAC ID
0446206858
Group Practice PAC ID
8820212749
Professional Enrollment ID
I20060825000079
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

  • 1030, Southeast Murphy Boulevard, Joplin, Jasper County, Missouri, 64801, United States

    JOPLIN, MO 648015043

    Phone: (417) 782-3488

    Fax: (417) 782-8150

    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)

CMS reports 4 Open Payments records for all available years, with a total value of $77.

Total Amount is formed as General ($77) + Research ($0) + Ownership ($0) = $77.

Last reported payment date: 2024-03-04 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($77).

Total Amount

$77

General + Research + Ownership

Payments

4

Total payment records

General Amount

$77

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-04

Latest reported date

Top Companies

Largest payers in this snapshot

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
92014Established patient complete exam of visual system116116$0
92134Imaging of retina6153$0
99213Established patient office or other outpatient visit, 20-29 minutes5934$0
92250Photography of the retina3534$0
92133Imaging of optic nerve1812$0
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Insurance plans in this area (ZIP 64801)

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Provider's Procedures

Unknown Individual performs procedures in Vision Therapy Optometrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYMO92134Diagnostic imaging of retina4742

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1770508889.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Vision Therapy Optometrist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Joplin?
Public fields place Unknown Individual around Joplin, Missouri. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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