Unknown Individual – Clinical Cardiac Electrophysiology Physician, NPI 1861489403

Unknown Individual is a healthcare provider. based in Knoxville, Tennessee. specializing in Clinical Cardiac Electrophysiology Physician. They hold a License No. 15086 (TN). The NPI Number for Unknown Individual is 1861489403

Main info

Organization
Inactive
43 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1861489403
Phone
(865) 691-4850
Address
9330 PARK WEST BLVD
Deactivation Date
17 December 2021

Doctor Profile

Medical School Name
MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
Secondary Phone
8653731975
Graduation Year
1983 (43 years ago)
PAC ID
7113909011
Group Practice PAC ID
2860305463
Professional Enrollment ID
I20040603001344
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

  • 9330, Park West Boulevard, Park West, Cedar Bluff, Knoxville, Knox County, East Tennessee, Tennessee, 37923, United States

    SUITE 202

    KNOXVILLE, TN 379234308

    Phone: (865) 691-4850

    Fax: (865) 694-8018

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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 37923)

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Provider's Procedures

Unknown Individual performs procedures in Clinical Cardiac Electrophysiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)TN78452Nuclear medicine study of vessels of heart using drugs or exercise multiple studies198198
CARDIOVASCULAR DISEASE (CARDIOLOGY)TN93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report11671017
CARDIOVASCULAR DISEASE (CARDIOLOGY)TN93280Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report228172

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: 2860305463View full group profile
NameSpecialtyState
Nurse PractitionerTN
Internal MedicineTN
Nurse PractitionerTN
Nurse PractitionerTN
Internal MedicineTN
Nurse PractitionerTN
Family PracticeTN
-TN
Physician AssistantTN
Nurse PractitionerTN

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1861489403 uniquely identifies Unknown Individual in U.S. healthcare data.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Clinical Cardiac Electrophysiology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Knoxville, Tennessee in registry-derived data.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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