Unknown Individual – Family Nurse Practitioner, NPI 1083873996

Unknown Individual is a healthcare provider. based in Boardman, Ohio. specializing in Family Nurse Practitioner. They hold a License No. APRN.CNP.16860 (OH). The NPI Number for Unknown Individual is 1083873996

Main info

Organization
Inactive
18 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1083873996
Phone
(330) 729-2929
Address
8401 MARKET ST
Deactivation Date
25 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3307294350
Graduation Year
2008 (18 years ago)
PAC ID
6305918806
Group Practice PAC ID
9234318270
Professional Enrollment ID
I20150219001258
Data current as of
20 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

  • Saint Elizabeth Boardman Hospital, 8401, Market Street, Woodworth, Boardman, Mahoning County, Ohio, 44512, United States

    BOARDMAN, OH 445126725

    Phone: (330) 729-2929

    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 $68.

Total Amount is formed as General ($68) + Research ($0) + Ownership ($0) = $68.

Last reported payment date: 2023-02-22 • Largest payer in this snapshot: ABBVIE INC. ($68).

Total Amount

$68

General + Research + Ownership

Payments

1

Total payment records

General Amount

$68

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-02-22

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$68
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 44512)

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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: 9234318270View full group profile

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1083873996 for Unknown Individual.
What should I verify if Unknown Individual is listed inactive?
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 Nurse Practitioner for Unknown Individual. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Boardman, Ohio 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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