Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1114348034

Unknown Individual is a healthcare provider. based in Chevy chase, Maryland. specializing in Certified Registered Nurse Anesthetist. They hold a License No. D179217 (IA). The NPI Number for Unknown Individual is 1114348034

Main info

Organization
Inactive
13 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1114348034
Phone
(301) 718-9800
Address
5530 WISCONSIN AVE
Deactivation Date
22 January 2026

Doctor Profile

Medical School Name
UNIFORMED SERVICES UHS FE HEBERT SCHOOL OF MED
Secondary Phone
4106019000
Graduation Year
2013 (13 years ago)
PAC ID
1153600408
Group Practice PAC ID
1850283144
Professional Enrollment ID
I20190924003269
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:0State licenses:3Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 5530 WISCONSIN AVE

    STE 1620

    CHEVY CHASE, MD 208154322

    Phone: (301) 718-9800

    Type: Mailing

  • 403 1st St SE

    Belmond, IA 504211201

    Phone: (641) 444-3500

    Fax: (319) 343-1161

    Type: Location

  • 1316 S Main St

    Clarion, IA 505252019

    Phone: (515) 532-2811

    Fax: (515) 532-3119

    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.

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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.

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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 20815)

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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: 1850283144View full group profile

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1114348034.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Chevy Chase, Maryland in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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