Unknown Individual – Psychiatry Physician, NPI 1922083161

Unknown Individual is a healthcare provider. based in Cumberland, Maryland. specializing in Psychiatry Physician. They hold a License No. D0000410 (MD). The NPI Number for Unknown Individual is 1922083161

Main info

Organization
Inactive
65 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1922083161
Phone
(240) 964-8585
Address
12502 WILLOWBROOK RD
Deactivation Date
15 March 2023

Doctor Profile

Medical School Name
JS WEILL MEDICAL COLLEGE, CORNELL UNIVERSITY
Secondary Phone
-
Graduation Year
1961 (65 years ago)
PAC ID
4486780624
Group Practice PAC ID
7113900655
Professional Enrollment ID
I20100327000022
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

  • Willowbrook Road, Cumberland, Allegany County, Maryland, 21502, United States

    SUITE 380

    CUMBERLAND, MD 215026393

    Phone: (240) 964-8585

    Fax: (240) 964-8586

    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 21502)

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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: 7113900655View full group profile

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1922083161.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Cumberland, Maryland in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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