Unknown Individual – Family Medicine Physician, NPI 1750455564

Unknown Individual is a healthcare provider. based in Jackson, Michigan. specializing in Family Medicine Physician. They hold a License No. 4301062371 (MI). The NPI Number for Unknown Individual is 1750455564

Main info

Organization
Inactive
33 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1750455564
Phone
(517) 788-6470
Address
2600 SPRING ARBOR RD
Deactivation Date
19 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1993 (33 years ago)
PAC ID
5597714592
Professional Enrollment ID
I20050121000556

Contacts

Secure Messaging
djones489052@direct.hfhs.org
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

  • 2600, Spring Arbor Road, Summit Hills, Summit Township, Jackson County, Michigan, 49203, United States

    JACKSON, MI 492033604

    Phone: (517) 788-6470

    Fax: (517) 788-5547

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $1.

Total Amount is formed as General ($1) + Research ($0) + Ownership ($0) = $1.

Last reported payment date: 2023-01-13 • Largest payer in this snapshot: Sumitomo Pharma America, Inc. ($1).

Total Amount

$1

General + Research + Ownership

Payments

1

Total payment records

General Amount

$1

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-13

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes575264$0
83036Hemoglobin a1c level251110$0
99214Established patient office or other outpatient visit, 30-39 minutes227101$0
81003Automated urinalysis test163146$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit147147$0
View full utilization report →

Insurance plans in this area (ZIP 49203)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEMI82270Stool analysis for blood to screen for colon tumors6666
FAMILY MEDICINEMI83036Hemoglobin A1C level643265

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 1750455564.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Family Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Jackson, Michigan. Check all listed addresses for suites or satellite offices.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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