Unknown Individual – Emergency Medicine Physician, NPI 1841296423
Emergency Medicine Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
1400 RIDGEWOOD RD
NEOSHO, MO 648501392
Phone: (620) 202-0096
Type: Mailing
11074 MICA LN
NEOSHO, MO 64850
Phone: (620) 202-0096
Type: Location
2 S Hospital Dr
Murphysboro, IL 629663333
Phone: (618) 684-3156
Type: Location
405 W Jackson St
Carbondale, IL 629011462
Phone: (618) 549-0721
Type: Location
201 S 14th St
Herrin, IL 629483631
Phone: (618) 942-2171
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $15.
Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.
Last reported payment date: 2023-05-24 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($15).
Total Amount
$15
General + Research + Ownership
Payments
1
Total payment records
General Amount
$15
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $15 |
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 198 | 193 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 114 | 113 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 95 | 91 | $0 |
| 99291 | Critical care, first 30-74 minutes | 43 | 43 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 27 | 26 | $0 |
Insurance plans in this area (ZIP 64850)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OK | |
| - | IA | |
| - | IA |
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