Unknown Individual – Emergency Medicine Physician, NPI 1881613594

Unknown Individual is a healthcare provider. based in Marion, Indiana. specializing in Emergency Medicine Physician. They hold a License No. 01056460 (IN). The NPI Number for Unknown Individual is 1881613594

Main info

Organization
Inactive
25 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1881613594
Phone
(765) 660-6900
Address
441 N WABASH AVE
Deactivation Date
19 July 2021

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7656607616
Graduation Year
2001 (25 years ago)
PAC ID
5799761441
Group Practice PAC ID
9133023625
Professional Enrollment ID
I20040624001690
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

  • 441, Wabash Avenue, Wamac, Marion County, Illinois, 62801, United States

    MARION, IN 469522612

    Phone: (765) 660-6900

    Fax: (765) 662-4528

    Type: Location

  • 2026, Springmill Road, Fort Wayne, Allen County, Indiana, 46845, United States

    FORT WAYNE, IN 468459728

    Phone: (260) 637-1813

    Fax: (260) 407-8004

    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.

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 46952)

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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: 9133023625View full group profile
NameSpecialtyState
-IN
Emergency MedicineIN
Family PracticeIN
Critical Care (Intensivists), NephrologyIN
Family PracticeIN
Internal MedicineIL
Emergency Medicine, PathologyIN
Emergency MedicineIN
Pulmonary Disease, Internal MedicineIN
Nurse PractitionerIN

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 1881613594.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Marion, Indiana?
If you are local to Marion, Indiana, Unknown Individual may be relevant to your search.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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