Unknown Individual – Obstetrics & Gynecology Physician, NPI 1003811217

Obstetrics & Gynecology Physician

Unknown Individual is a healthcare provider. based in New albany, Indiana. specializing in Obstetrics & Gynecology Physician. They hold a License No. 01027631 (IN). The NPI Number for Unknown Individual is 1003811217

Main info

Organization

Inactive

53 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1003811217

Phone

(812) 945-5233

Address

1919 STATE ST

Deactivation Date

30 August 2023

Doctor Profile

Medical School Name

UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE

Secondary Phone

8129455233113

Graduation Year

1973 (53 years ago)

PAC ID

4880611532

Group Practice PAC ID

9739106485

Professional Enrollment ID

I20100816000979

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience19

Completeness75

Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

1919, State Street, New Albany, Floyd County, Indiana, 47150, United States
STE 340
NEW ALBANY, IN 471506807
Phone: (812) 945-5233
Fax: (812) 945-2804
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 47150)

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Provider's Procedures

Unknown Individual performs procedures in Obstetrics & Gynecology Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
OBSTETRICS/GYNECOLOGY	IN	81002	Urinalysis, manual test	15	15

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 9739106485View full group profile

Name	Specialty	State
ALESHIA MARIE THOMPSON (MD)	O B S T E T R I C S/ G Y N E C O L O G Y	IN
DR. TAWANA COATES (MD, MPH)	O B S T E T R I C S/ G Y N E C O L O G Y	IN
LESLEY G LANTZ (NP)	Nurse Practitioner	IN
DR. BRAIDI ROSE HUECKER (M.D.)	-	IN
DR. STEPHEN M BALDWIN (M.D.)	O B S T E T R I C S/ G Y N E C O L O G Y	IN
DANIELLE BIBELHAUSER (APRN)	Nurse Practitioner	IN
HEATHER ANNE LEWIS (M.D.)	O B S T E T R I C S/ G Y N E C O L O G Y	IN
MELISSA JARLES ALLEN (MD)	O B S T E T R I C S/ G Y N E C O L O G Y	IN
TERRA ROBERTSON (NP)	Nurse Practitioner	IN
DR. CAROL C BORDEN (M.D.)	O B S T E T R I C S/ G Y N E C O L O G Y	IN