Unknown Individual – Psychiatry Physician, NPI 1679523609

Unknown Individual is a healthcare provider. based in Memphis, Tennessee. specializing in Psychiatry Physician. They hold a License No. MD010310 (TN). The NPI Number for Unknown Individual is 1679523609

Main info

Organization
Inactive
51 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1679523609
Phone
(901) 683-0030
Address
6401 POPLAR AVENUE
Deactivation Date
10 April 2025

Doctor Profile

Medical School Name
UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Secondary Phone
9016830030
Graduation Year
1975 (51 years ago)
PAC ID
8628242054
Professional Enrollment ID
I20111122000365
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 6401, Poplar Avenue, Memphis, Shelby County, Tennessee, 38119, United States

    SUITE 318

    MEMPHIS, TN 381194840

    Phone: (901) 683-0030

    Fax: (901) 683-9522

    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 $14.

Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.

Last reported payment date: 2023-01-27 • Largest payer in this snapshot: Teva Pharmaceuticals USA, Inc. ($14).

Total Amount

$14

General + Research + Ownership

Payments

1

Total payment records

General Amount

$14

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-27

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
90833Psychotherapy with evaluation and management visit, 30 minutes8675$0
99212Established patient office or other outpatient visit, 10-19 minutes6359$0
99213Established patient office or other outpatient visit, 20-29 minutes2421$0
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Insurance plans in this area (ZIP 38119)

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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
PSYCHIATRYTN90833Psychotherapy, 30 minutes with patient and/or family member2914

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1679523609.
Does inactive mean outdated data 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 Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Memphis, Tennessee?
For routing, start with Memphis, Tennessee for Unknown Individual, then verify phone and hours locally.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.