Unknown Individual – Family Medicine Physician, NPI 1366485971

Unknown Individual is a healthcare provider. based in Newberry, Michigan. specializing in Family Medicine Physician. They hold a License No. 037960 (MI). The NPI Number for Unknown Individual is 1366485971

Main info

Organization
Inactive
52 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1366485971
Phone
(906) 293-9200
Address
502 W HARRIE ST
Deactivation Date
31 January 2022

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF WISCONSIN
Secondary Phone
9066438585
Graduation Year
1974 (52 years ago)
PAC ID
0648166702
Group Practice PAC ID
1456420876
Professional Enrollment ID
I20040225000599
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Helen Newberry Joy Hospital, 502, West Harrie Street, Newberry, McMillan Township, Luce County, Michigan, 49868, United States

    NEWBERRY, MI 498681209

    Phone: (906) 293-9200

    Fax: (906) 293-9201

    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 49868)

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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: 1456420876View full group profile
NameSpecialtyState
Family PracticeMI
Nurse PractitionerMI
-MI
Physician AssistantMI
Internal MedicineMI
Emergency MedicineMI
Certified Registered Nurse Anesthetist (Crna)MI
Nurse PractitionerMI
Emergency Medicine, Internal MedicineMI
Family PracticeMI

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 1366485971.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Newberry, Michigan. Check all listed addresses for suites or satellite offices.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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