Unknown Individual – Family Medicine Physician, NPI 1174520217

Unknown Individual is a healthcare provider. based in Steubenville, Ohio. specializing in Family Medicine Physician. They hold a License No. 35.041174 (OH). The NPI Number for Unknown Individual is 1174520217

Main info

Organization
Inactive
52 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1174520217
Phone
(740) 314-8420
Address
4232 MALL DR
Deactivation Date
8 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7402641656
Graduation Year
1974 (52 years ago)
PAC ID
0042300139
Group Practice PAC ID
5496648875
Professional Enrollment ID
I20071212000765
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

  • Mall Drive, Becker Highlands, Steubenville, Jefferson County, Ohio, 43952, United States

    STEUBENVILLE, OH 439523010

    Phone: (740) 314-8420

    Fax: (740) 314-8421

    Type: Location

  • Trinity Medical Center East, 380, Summit Avenue, Lawson - Ross Park Historic District, Pleasant Heights, Steubenville, Jefferson County, Ohio, 43952, United States

    MSO PHYSICIAN BILLING

    STEUBENVILLE, OH 439522667

    Phone: (740) 283-7597

    Fax: (740) 283-7190

    Type: Mailing

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.

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 43952)

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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: 5496648875View full group profile
NameSpecialtyState
Internal Medicine, HospitalistOH
Internal MedicineOH
Qualified AudiologistOH
Nurse PractitionerOH
G A S T R O E N T E R O L O G YOH
-OH
Nurse PractitionerOH
-OH
-OH
Orthopedic SurgeryOH

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1174520217.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's primary classification?
Family Medicine Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Steubenville, Ohio; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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