Unknown Individual – Family Medicine Physician, NPI 1003819202

Unknown Individual is a healthcare provider. based in Lancaster, Ohio. specializing in Family Medicine Physician. They hold a License No. 34002308A (OH). The NPI Number for Unknown Individual is 1003819202

Main info

Organization
Inactive
54 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1003819202
Phone
(740) 687-8854
Address
1153 E MAIN ST
Deactivation Date
25 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7406896758
Graduation Year
1972 (54 years ago)
PAC ID
5395819908
Group Practice PAC ID
9133316805
Professional Enrollment ID
I20080730000720
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

  • East Main Street, Lancaster, Dallas County, Texas, 75146, United States of America

    LANCASTER, OH 431304056

    Phone: (740) 687-8854

    Fax: (740) 687-8230

    Type: Mailing

  • Main Street, Hornby-with-Farleton, Hornby, Lancaster, Lancashire, North West England, England, LA2 8JR, United Kingdom

    LANCASTER, OH 431304056

    Phone: (740) 689-6758

    Fax: (740) 689-6759

    Type: Location

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 $26.

Total Amount is formed as General ($26) + Research ($0) + Ownership ($0) = $26.

Last reported payment date: 2023-06-01 • Largest payer in this snapshot: Nevro Corp. ($26).

Total Amount

$26

General + Research + Ownership

Payments

1

Total payment records

General Amount

$26

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-06-01

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Nevro Corp.$26
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 43130)

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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 MEDICINEOH83036Hemoglobin A1C level1716

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: 9133316805View full group profile
NameSpecialtyState
Family PracticeOH
Clinical Social WorkerOH
Family PracticeOH
Family PracticeOH
Nurse PractitionerOH
Nurse PractitionerOH
Family PracticeOH
-OH
-OH
Mental Health CounselorOH

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1003819202 on file in the registry.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
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 associated with Lancaster?
Public fields place Unknown Individual around Lancaster, Ohio. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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