Unknown Individual – Psychiatry Physician, NPI 1023069077

Unknown Individual is a healthcare provider. based in Kokomo, Indiana. specializing in Psychiatry Physician. They hold a License No. 35-019550 (OH). The NPI Number for Unknown Individual is 1023069077

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1023069077
Phone
Not provided
Address
4654 WEXMOOR DR
Deactivation Date
1 November 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 4654, Wexmoor Drive, Kokomo, Howard County, Indiana, 46902, United States

    KOKOMO, IN 469029597

    Phone:

    Type: Mailing

  • 217, Farabee Drive North, Lafayette, Tippecanoe County, Indiana, 47905, United States

    LAFAYETTE, IN 479055910

    Phone: (765) 467-1312

    Type: Location

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: 2023-02-07 • 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

2023-02-07

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46902)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1023069077 on file in the registry.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Psychiatry Physician in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Kokomo?
Public fields place Unknown Individual around Kokomo, Indiana. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.