Unknown Individual – Psychiatry Physician, NPI 1124050984

Unknown Individual is a healthcare provider. based in West plains, Missouri. specializing in Psychiatry Physician. They hold a License No. OS003310L (PA). The NPI Number for Unknown Individual is 1124050984

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1124050984
Phone
(417) 257-6782
Address
909 N KENTUCKY AVE
Deactivation Date
7 September 2021
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

  • 909, North Kentucky Avenue, West Plains, Howell County, Missouri, 65775, United States

    WEST PLAINS, MO 657752024

    Phone: (417) 257-6782

    Fax: (417) 257-5876

    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.

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Medicare Enrollment & Revalidation

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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 65775)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1124050984.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to West Plains, Missouri in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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