Unknown Individual – Child & Adolescent Psychiatry Physician, NPI 1548219207

Child & Adolescent Psychiatry Physician

Unknown Individual is a healthcare provider. based in Greenwood, Indiana. specializing in Child & Adolescent Psychiatry Physician. They hold a License No. 01071938A (IN). The NPI Number for Unknown Individual is 1548219207

Main info

Organization

Inactive

58 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1548219207

Phone

(317) 528-4886

Address

1040 SIERRA DRIVE

Deactivation Date

6 September 2023

Doctor Profile

Medical School Name

WASHINGTON UNIVERSITY SCHOOL OF MEDICINE

Secondary Phone

7659660511

Graduation Year

1968 (58 years ago)

PAC ID

6800812397

Group Practice PAC ID

1759280118

Professional Enrollment ID

I20130529000588

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience23

Completeness75

Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

Sierra Drive, Greenwood, Johnson County, Indiana, 46142:46227, United States
SUITE 400
GREENWOOD, IN 461437241
Phone: (317) 528-4886
Fax: (317) 859-8239
Type: Mailing
Frranciscan Dyer Hosptial, 24, Joliet Street, Dyer, Lake County, Indiana, 46311, United States
DYER, IN 463111705
Phone: (219) 322-5747
Fax: (219) 864-2282
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 46143)

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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: 1759280118View full group profile

Name	Specialty	State
SANDRA SMITH	-	IN
ROSEANNA L PARKHURST GATEWOOD (FNP)	Nurse Practitioner	ME
WILLIAM N. ARNOLD (MD)	Psychiatry, Geriatric Psychiatry	IN
JENNIFER A ARNETT (RNC)	-	IN
MARGARET ANNE TITUS-QUEAR (NP)	Nurse Practitioner	IN
KARI L. KERNEK (M.D., PH.D.)	P S Y C H I A T R Y	IN
CLARISSE NYAM	-	OH
STEPHANIE JO DOENCH (FNP-C)	Nurse Practitioner	KY
ANN MICHELLE WEBB (CFNP)	Nurse Practitioner	IN
DR. ANJUM S ASHRAF (MD)	Psychiatry, Geriatric Psychiatry	IN

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?

You can start verification with NPI 1548219207 for Unknown Individual, then check state licensing separately.

Why might Unknown Individual appear inactive while still practicing?

We display what the registry publishes: Unknown Individual appears inactive there.

What is Unknown Individual's primary classification?

Child & Adolescent Psychiatry Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.

What area does Unknown Individual serve?

Unknown Individual's listing highlights Greenwood, Indiana; more addresses can appear in NPPES.

Is specialty guaranteed by NPI alone?

Taxonomy selections describe intent; scope of practice still follows state law.