Unknown Individual – Cardiovascular Disease Physician, NPI 1225023328

Cardiovascular Disease Physician

Unknown Individual is a healthcare provider. based in Farmington, Utah. specializing in Cardiovascular Disease Physician. They hold a License No. 168603-1205 (UT). The NPI Number for Unknown Individual is 1225023328

Main info

Organization

Inactive

47 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1225023328

Phone

(801) 776-0174

Address

444 W BOURNE CIR STE 200

Deactivation Date

30 March 2022

Doctor Profile

Medical School Name

UNIVERSITY OF UTAH SCHOOL OF MEDICINE

Secondary Phone

8012992482

Graduation Year

1979 (47 years ago)

PAC ID

9133026586

Group Practice PAC ID

2668493750

Professional Enrollment ID

I20050810000120

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

Provider Addresses for Unknown Individual

444 W BOURNE CIR STE 200
FARMINGTON, UT 84025
Phone: (801) 776-0174
Fax: (801) 825-3904
Type: Location
5682 S 3500 W Ste 2A
Roy, UT 840679108
Phone: (801) 776-0174
Type: Location

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 84025)

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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: 2668493750View full group profile

Name	Specialty	State
STEPHANIE L OLSEN (MD)	-	UT
CHRISTOPHER Y KIM (MD)	Cardiovascular Disease (Cardiology)	UT

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?

The federal identifier for Unknown Individual is NPI 1225023328.

Why would Unknown Individual's listing show inactive?

Inactive in NPPES means the identifier is not currently active in that dataset.

Can you summarize Unknown Individual's specialty in plain language?

Clinically, the directory lists Unknown Individual with Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.

Does Unknown Individual practice in Utah?

You will see Farmington, Utah on file for Unknown Individual alongside any extra practice locations.

What if Farmington, Utah seems incomplete?

Street-level detail can be omitted — open the full address list for this NPI.