Unknown Individual – Optometrist, NPI 1932245248

Unknown Individual is a healthcare provider. based in Kennett, Missouri. specializing in Optometrist. They hold a License No. T02701 (MO). The NPI Number for Unknown Individual is 1932245248

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1932245248
Phone
(573) 888-5896
Address
303 TEACO RD
Deactivation Date
31 July 2025

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
-
Graduation Year
1986 (40 years ago)
PAC ID
6507895034
Professional Enrollment ID
I20050805000006
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

  • 303, Teaco Road, Kennett, Dunklin County, Missouri, 63857, United States

    KENNETT, MO 638573237

    Phone: (573) 888-5896

    Fax: (573) 888-1501

    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 1 Open Payments records for all available years, with a total value of $20.

Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.

Last reported payment date: 2024-10-03 • Largest payer in this snapshot: Tarsus Pharmaceuticals, Inc. ($20).

Total Amount

$20

General + Research + Ownership

Payments

1

Total payment records

General Amount

$20

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-03

Latest reported date

Top Companies

Largest payers in this snapshot

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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 63857)

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Provider's Procedures

Unknown Individual performs procedures in Optometrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYMO92083Measurement of field of vision during daylight conditions361129
OPTOMETRYMO92134Diagnostic imaging of retina291194

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1932245248 as the unique 10-digit identifier.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Optometrist. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Kennett, Missouri.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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