Unknown Individual – Addiction Medicine (Family Medicine) Physician, NPI 1124073283

Unknown Individual is a healthcare provider. based in Gahanna, Ohio. specializing in Addiction Medicine (Family Medicine) Physician. They hold a License No. 35048255 (OH). The NPI Number for Unknown Individual is 1124073283

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1124073283
Phone
(614) 293-2614
Address
920 N Hamilton Rd
Deactivation Date
3 April 2024

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
6145684646
Graduation Year
1981 (45 years ago)
PAC ID
3476446493
Group Practice PAC ID
6204196199
Professional Enrollment ID
I20040204000485
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

  • 920 N Hamilton Rd

    Ste. 300

    Gahanna, OH 432301757

    Phone: (614) 293-2614

    Fax: (614) 293-7001

    Type: Location

  • Elsinore Place, Walnut Hills, Cincinnati, Hamilton County, Ohio, 45202, United States

    CINCINNATI, OH 452021459

    Phone: (513) 834-7063

    Fax: (138) 731-5675

    Type: Mailing

  • 560, North Main Street, Downtown, Marion, Marion County, Ohio, 43302, United States

    MARION, OH 433022331

    Phone: (513) 834-7063

    Fax: (513) 873-1567

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $93.

Total Amount is formed as General ($93) + Research ($0) + Ownership ($0) = $93.

Last reported payment date: 2023-11-27 • Largest payer in this snapshot: Alkermes, Inc. ($49).

Total Amount

$93

General + Research + Ownership

Payments

5

Total payment records

General Amount

$93

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-27

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
99214Established patient office or other outpatient visit, 30-39 minutes2711$0
View full utilization report →

Insurance plans in this area (ZIP 43230)

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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: 6204196199View full group profile
NameSpecialtyState
Nurse PractitionerOH

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1124073283.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Addiction Medicine (Family Medicine) Physician. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Gahanna, Ohio for Unknown Individual; download NPPES for the complete set.
What if Gahanna, Ohio seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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