Unknown Individual – Adult Health Nurse Practitioner, NPI 1275635153

Unknown Individual is a healthcare provider. based in Canton, Ohio. specializing in Adult Health Nurse Practitioner. They hold a License No. NP-08921 (OH). The NPI Number for Unknown Individual is 1275635153

Main info

Organization
Inactive
20 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1275635153
Phone
(330) 477-0255
Address
4634 HILLS AND DALES RD NW
Deactivation Date
11 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3304770255
Graduation Year
2006 (20 years ago)
PAC ID
5395974448
Group Practice PAC ID
1153329800
Professional Enrollment ID
I20140212001410
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

  • 4634 HILLS AND DALES RD NW

    CANTON, OH 447081510

    Phone: (330) 477-0255

    Fax: (330) 477-7266

    Type: Location

  • 486, North Johnson Road, Sebring, Smith Township, Mahoning County, Ohio, 44672, United States

    SEBRING, OH 446721006

    Phone: (330) 938-2129

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 38 Open Payments records for all available years, with a total value of $725.

Total Amount is formed as General ($725) + Research ($0) + Ownership ($0) = $725.

Last reported payment date: 2024-05-21 • Largest payer in this snapshot: Lilly USA, LLC ($152).

Total Amount

$725

General + Research + Ownership

Payments

38

Total payment records

General Amount

$725

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-21

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44708)

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Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1275635153.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Adult Health Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Canton, Ohio?
If you are local to Canton, Ohio, Unknown Individual may be relevant to your search.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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