Unknown Individual – Psychiatry Physician, NPI 1093879272

Unknown Individual is a healthcare provider. based in Norman, Oklahoma. specializing in Psychiatry Physician. They hold a License No. 3642 (OK). The NPI Number for Unknown Individual is 1093879272

Main info

Organization
Inactive
30 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1093879272
Phone
(405) 579-4111
Address
2201 WESTPARK DR
Deactivation Date
7 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4055794111
Graduation Year
1996 (30 years ago)
PAC ID
8729240544
Group Practice PAC ID
3971866484
Professional Enrollment ID
I20120424000238
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

  • 2201, Westpark Drive, Norman, Cleveland County, Oklahoma, 73069, United States

    NORMAN, OK 730694012

    Phone: (405) 579-4111

    Fax: (405) 579-4223

    Type: Location

  • 520, 24th Avenue Southwest, Norman, Cleveland County, Oklahoma, 73069, United States

    NORMAN, OK 730695106

    Phone: (405) 570-4264

    Fax: (405) 701-5667

    Type: Mailing

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 $19.

Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.

Last reported payment date: 2023-02-14 • Largest payer in this snapshot: ABBVIE INC. ($19).

Total Amount

$19

General + Research + Ownership

Payments

1

Total payment records

General Amount

$19

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-02-14

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$19
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
99214Established patient office or other outpatient visit, 30-39 minutes5629$0
99213Established patient office or other outpatient visit, 20-29 minutes1511$0
View full utilization report →

Insurance plans in this area (ZIP 73069)

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Provider's Procedures

Unknown Individual performs procedures in Psychiatry Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PSYCHIATRYOK90833Psychotherapy, 30 minutes with patient and/or family member2414

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: 3971866484View full group profile
NameSpecialtyState
Mental Health CounselorOK
Nurse PractitionerOK
Physician AssistantOK
Clinical Social WorkerOK
P S Y C H I A T R YOK
Nurse PractitionerOK
Nurse PractitionerOK
Mental Health CounselorOK
Nurse PractitionerOK
Nurse PractitionerOK

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1093879272.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Psychiatry Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Norman, Oklahoma for Unknown Individual; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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