Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1750412987

Unknown Individual is a healthcare provider. based in Mount clemens, Michigan. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 4704164145 (MI). The NPI Number for Unknown Individual is 1750412987

Main info

Organization
Inactive
27 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1750412987
Phone
(586) 493-8747
Address
1000 HARRINGTON ST
Deactivation Date
10 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5864938000
Graduation Year
1999 (27 years ago)
PAC ID
2264616549
Group Practice PAC ID
2365668043
Professional Enrollment ID
I20110411000751
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

Provider Addresses for Unknown Individual

  • 1000 HARRINGTON ST

    MOUNT CLEMENS, MI 480432920

    Phone: (586) 493-8747

    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 48043)

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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: 2365668043View full group profile
NameSpecialtyState
Interventional Pain Management, AnesthesiologyMI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
A N E S T H E S I O L O G YMI
Certified Registered Nurse Anesthetist (Crna)MI
-IL

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 1750412987.
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 type of care does Unknown Individual provide?
Unknown Individual's profile centers on Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Mount Clemens, Michigan in the same public data insurers reference.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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