Unknown Individual – Psychiatry Physician, NPI 1780629006

Unknown Individual is a healthcare provider. based in Lees summit, Missouri. specializing in Psychiatry Physician. They hold a License No. 105026 (MO). The NPI Number for Unknown Individual is 1780629006

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1780629006
Phone
(816) 246-8000
Address
901 NE INDEPENDENCE AVE
Deactivation Date
31 May 2023
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

  • Northeast Independence Avenue, Lee's Summit, Jackson County, Missouri, 64064, United States

    LEES SUMMIT, MO 640865544

    Phone: (816) 246-8000

    Type: Location

  • 12909, Westgate Street, Nottingham by the Green, Overland Park, Johnson County, Kansas, 66213, United States

    OVERLAND PARK, KS 662132365

    Phone: (913) 626-4848

    Type: Mailing

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 64086)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1780629006 is assigned to Unknown Individual under the national enumeration system.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What kind of provider is Unknown Individual?
The page reflects Psychiatry Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Lees Summit, Missouri for Unknown Individual; download NPPES for the complete set.
What if Lees Summit, Missouri seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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