Unknown Individual – Community Based Hospice Care Agency, NPI 1124139100

Unknown Individual is a healthcare provider. based in Springfield, Missouri. specializing in Community Based Hospice Care Agency. They hold a License No. 4164 (OK). The NPI Number for Unknown Individual is 1124139100

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1124139100
Phone
(417) 891-9939
Address
1328 E EVERGREEN ST
Deactivation Date
24 June 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

  • 1328, East Evergreen Street, Doling Park, Springfield, Greene County, Missouri, 65803, United States

    SPRINGFIELD, MO 658034400

    Phone: (417) 891-9939

    Fax: (417) 891-9928

    Type: Mailing

  • 3, South Main Street, Miami, Ottawa County, Oklahoma, 74354, United States

    MIAMI, OK 743547022

    Phone: (918) 541-9325

    Fax: (918) 541-9127

    Type: Location

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 65803)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1124139100?
NPI 1124139100 belongs to Unknown Individual; compare other details if you need extra assurance.
Who updates status for Unknown Individual?
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 Community Based Hospice Care Agency. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Springfield?
Public fields place Unknown Individual around Springfield, Missouri. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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