Unknown Individual – Psychiatry Physician, NPI 1124055199

Unknown Individual is a healthcare provider. based in Ashland, Kentucky. specializing in Psychiatry Physician. They hold a License No. KY22004 (KY). The NPI Number for Unknown Individual is 1124055199

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1124055199
Phone
(606) 836-0604
Address
700 SAINT CHRISTOPHER DR STE 101
Deactivation Date
30 October 2024
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

Provider Addresses for Unknown Individual

  • 700 SAINT CHRISTOPHER DR STE 101

    ASHLAND, KY 411017061

    Phone: (606) 836-0604

    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 1 Open Payments records for all available years, with a total value of $17.

Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.

Last reported payment date: 2023-06-05 • Largest payer in this snapshot: Gilead Sciences, Inc. ($17).

Total Amount

$17

General + Research + Ownership

Payments

1

Total payment records

General Amount

$17

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-06-05

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Gilead Sciences, Inc.$17
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.

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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 41101)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1124055199.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's primary classification?
Psychiatry Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Ashland, Kentucky in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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