Unknown Individual – Otolaryngology/Facial Plastic Surgery Physician, NPI 1023120110

Unknown Individual is a healthcare provider. based in Sedalia, Missouri. specializing in Otolaryngology/Facial Plastic Surgery Physician. They hold a License No. R4861 (MO). The NPI Number for Unknown Individual is 1023120110

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1023120110
Phone
(660) 827-4433
Address
1710 S LAFAYETTE AVE
Deactivation Date
20 September 2022
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

  • 1710, South Lafayette Avenue, Sedalia, Pettis County, Missouri, 65301, United States

    SEDALIA, MO 653017542

    Phone: (660) 827-4433

    Fax: (660) 827-4466

    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)

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 65301)

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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 1023120110 on file in the registry.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Otolaryngology/Facial Plastic Surgery Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Sedalia, Missouri as the reference point for Unknown Individual, then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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