Unknown Individual – Pediatric Nephrology Physician, NPI 1144246760

Unknown Individual is a healthcare provider. based in Grand rapids, Michigan. specializing in Pediatric Nephrology Physician. They hold a License No. 4301502849 (MI). The NPI Number for Unknown Individual is 1144246760

Main info

Organization
Inactive
35 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1144246760
Phone
Not provided
Address
100 MICHIGAN ST NE # MC845
Deactivation Date
18 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7207771234
Graduation Year
1991 (35 years ago)
PAC ID
9335285923
Group Practice PAC ID
3476465667
Professional Enrollment ID
I20150916001480

Contacts

Secure Messaging
jgoebel267314@epic00.shdirect.org
FHIR Endpoint
https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • 100 MICHIGAN ST NE # MC845

    GRAND RAPIDS, MI 495032560

    Phone:

    Type: Mailing

  • Grand Rapids, Kent County, Michigan, United States

    GRAND RAPIDS, MI 495032530

    Phone: (616) 267-2400

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $332.

Total Amount is formed as General ($332) + Research ($0) + Ownership ($0) = $332.

Last reported payment date: 2024-06-01 • Largest payer in this snapshot: Alexion Pharmaceuticals, Inc. ($141).

Total Amount

$332

General + Research + Ownership

Payments

6

Total payment records

General Amount

$332

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-01

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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 49503)

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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: 3476465667View full group profile
NameSpecialtyState
-CO
Family PracticeCO
Advanced Heart Failure And Transplant Cardiology, Cardiac Electrophysiology, Cardiovascular Disease (Cardiology), Internal MedicineCO
Emergency MedicineCO
Emergency MedicineCO
-CO
-CO
Emergency MedicineCO
-CO
-CO

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 1144246760.
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 Pediatric Nephrology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Grand Rapids, Michigan?
If you are local to Grand Rapids, Michigan, Unknown Individual may be relevant to your search.
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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