Unknown Individual – Psychiatry Physician, NPI 1902991706

Unknown Individual is a healthcare provider. based in Memphis, Tennessee. specializing in Psychiatry Physician. They hold a License No. MD40315 (TN). The NPI Number for Unknown Individual is 1902991706

Main info

Organization
Inactive
23 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1902991706
Phone
(901) 767-1136
Address
6005 PARK AVE STE 630B
Deactivation Date
16 October 2025

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
9018215600
Graduation Year
2003 (23 years ago)
PAC ID
2668569914
Group Practice PAC ID
5991807570
Professional Enrollment ID
I20080114000196
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

  • Park Avenue, White Station, Memphis, Shelby County, Tennessee, 38120, United States

    MEMPHIS, TN 381195226

    Phone: (901) 767-1136

    Fax: (901) 767-0476

    Type: Location

  • Island Drive, Harbor Town, Memphis, Shelby County, West Tennessee, Tennessee, 38103, United States

    UNIT 101

    MEMPHIS, TN 381039062

    Phone: (901) 237-0633

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 297 Open Payments records for all available years, with a total value of $4,803.

Total Amount is formed as General ($4,803) + Research ($0) + Ownership ($0) = $4,803.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($845).

Total Amount

$4,803

General + Research + Ownership

Payments

297

Total payment records

General Amount

$4,803

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

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
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes30537$0
99213Established patient office or other outpatient visit, 20-29 minutes212128$0
96372Injection of drug or substance under skin or into muscle9751$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes9314$0
90792Psychiatric diagnostic evaluation with medical services7567$0
View full utilization report →

Insurance plans in this area (ZIP 38119)

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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: 5991807570View full group profile

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1902991706 in the public NPI dataset.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Psychiatry Physician in this dataset. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Memphis, Tennessee; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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