Unknown Individual – Podiatrist, NPI 1114929098

Unknown Individual is a healthcare provider. based in Louisville, Kentucky. specializing in Podiatrist. They hold a License No. 00355 (KY). The NPI Number for Unknown Individual is 1114929098

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1114929098
Phone
(502) 366-1479
Address
4602 SOUTHERN PARKWAY
Deactivation Date
25 December 2025
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

  • 4602, Southern Parkway, Southern Heights, Louisville, Jefferson County, Kentucky, 40214, United States

    SUITE 1B

    LOUISVILLE, KY 402140000

    Phone: (502) 366-1479

    Fax: (502) 366-6718

    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)

CMS reports 5 Open Payments records for all available years, with a total value of $116.

Total Amount is formed as General ($116) + Research ($0) + Ownership ($0) = $116.

Last reported payment date: 2023-02-27 • Largest payer in this snapshot: Smith+Nephew, Inc. ($30).

Total Amount

$116

General + Research + Ownership

Payments

5

Total payment records

General Amount

$116

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-02-27

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
11721Removal of fingernails or toenails, 6 or more nails2723$0
99213Established patient office or other outpatient visit, 20-29 minutes1916$0
99212Established patient office or other outpatient visit, 10-19 minutes1817$0
99203New patient office or other outpatient visit, 30-44 minutes1616$0
11056Removal of noncancer thickened skin growth, 2-4 growths1312$0
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Insurance plans in this area (ZIP 40214)

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Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1114929098 — the number used across U.S. healthcare to identify this provider.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Podiatrist. Clinical services aligned with this taxonomy classification.
Where in Kentucky is Unknown Individual registered?
Use Louisville, Kentucky as the headline location for Unknown Individual here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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