Unknown Individual – Family Medicine Physician, NPI 1922159722

Unknown Individual is a healthcare provider. based in Imlay city, Michigan. specializing in Family Medicine Physician. They hold a License No. 5101009029 (MI). The NPI Number for Unknown Individual is 1922159722

Main info

Organization
Inactive
42 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1922159722
Phone
(810) 724-1600
Address
6800 NEWARK RD
Deactivation Date
31 January 2022

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
-
Graduation Year
1984 (42 years ago)
PAC ID
7012012701
Professional Enrollment ID
I20070425000533
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

  • 6800, Newark Road, Imlay City, Attica Township, Lapeer County, Michigan, 48444, United States

    STE 300

    IMLAY CITY, MI 484449656

    Phone: (810) 724-1600

    Fax: (810) 724-1603

    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.

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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 48444)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1922159722 on file in the registry.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Family Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Imlay City?
Unknown Individual currently maps to Imlay City, Michigan in this extract.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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