Unknown Individual – Family Medicine Physician, NPI 1790788164
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
1220 Biltmore Dr
Lawrence, KS 660491995
Phone: (785) 331-1700
Fax: (785) 331-1799
Type: Location
805, New Hampshire Street, Downtown Lawrence, Lawrence, Douglas County, Kansas, 66044, United States
LAWRENCE, KS 660442774
Phone: (785) 856-0452
Fax: (785) 749-3621
Type: Mailing
West 7th Street, Chanute, Neosho County, Kansas, 66720, United States
CHANUTE, KS 667202505
Phone: (620) 431-0023
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 $73.
Total Amount is formed as General ($73) + Research ($0) + Ownership ($0) = $73.
Last reported payment date: 2023-02-21 • Largest payer in this snapshot: ABBVIE INC. ($73).
Total Amount
$73
General + Research + Ownership
Payments
1
Total payment records
General Amount
$73
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-02-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $73 |
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 66049)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | KS | 90670 | Pneumococcal vaccine for injection into muscle | 17 | 17 |
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