Unknown Individual – Surgery Physician, NPI 1356455125

Unknown Individual is a healthcare provider. based in Bolivar, Missouri. specializing in Surgery Physician. They hold a License No. MD29059 (MO). The NPI Number for Unknown Individual is 1356455125

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1356455125
Phone
(417) 326-7676
Address
1500 N OAKLAND AVE
Deactivation Date
3 April 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

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Provider Addresses for Unknown Individual

  • Citizens Memorial Hospital, 1500, North Oakland Avenue, Bolivar, Polk County, Missouri, 65613, United States

    BOLIVAR, MO 656133011

    Phone: (417) 326-7676

    Fax: (417) 326-4882

    Type: Mailing

  • North Butterfield Road, Bolivar, Polk County, Missouri, 65613, United States

    BOLIVAR, MO 65613

    Phone: (417) 326-7676

    Fax: (417) 326-4882

    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.

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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 65613)

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Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1356455125.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Surgery Physician. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Bolivar, Missouri. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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