Unknown Individual – Colon & Rectal Surgery Physician, NPI 1942202015

Unknown Individual is a healthcare provider. based in Mooresville, Indiana. specializing in Colon & Rectal Surgery Physician. They hold a License No. 01040001A (IN). The NPI Number for Unknown Individual is 1942202015

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1942202015
Phone
(317) 834-2020
Address
1215 HADLEY RD
Deactivation Date
5 June 2025

Doctor Profile

Medical School Name
UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL
Secondary Phone
3178897906
Graduation Year
1985 (41 years ago)
PAC ID
1456303692
Group Practice PAC ID
3072790682
Professional Enrollment ID
I20100913000197
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

  • 1215, Hadley Road, Young, Mooresville, Morgan County, Indiana, 46158, United States

    STE 201

    MOORESVILLE, IN 461582905

    Phone: (317) 834-2020

    Fax: (317) 831-9292

    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 46158)

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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: 3072790682View full group profile

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1942202015.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Colon & Rectal Surgery Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Mooresville, Indiana?
For routing, start with Mooresville, Indiana for Unknown Individual, then verify phone and hours locally.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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