Unknown Individual – Psychiatry Physician, NPI 1356450340

Psychiatry Physician

Unknown Individual is a healthcare provider. based in Bowling green, Ohio. specializing in Psychiatry Physician. They hold a License No. 35-079917 (OH). The NPI Number for Unknown Individual is 1356450340

Main info

Organization

Inactive

27 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1356450340

Phone

(419) 352-6666

Address

970 W WOOSTER ST

Deactivation Date

29 March 2023

Doctor Profile

Medical School Name

MEDICAL COLLEGE OF OHIO

Secondary Phone

4193811881

Graduation Year

1999 (27 years ago)

PAC ID

8022041359

Group Practice PAC ID

0143133181

Professional Enrollment ID

I20050916000015

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

970, West Wooster Street, Foxgate Farm, Westgate Homes, Bowling Green, Wood County, Ohio, 43402, United States
SUITE 124, PSYCHOLOGICAL RESOURCES
BOWLING GREEN, OH 434022643
Phone: (419) 352-6666
Type: Location
520, Pine Valley Drive, Westgate Homes, Bowling Green, Wood County, Ohio, 43402, United States
BOWLING GREEN, OH 434025202
Phone: (419) 276-3801
Fax: (419) 423-7854
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 43402)

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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: 0143133181View full group profile

Name	Specialty	State
MR. STEVEN DEAN THOMSON (MD)	-	OH
ROBERT JAMES COOLEY (PHD)	Clinical Psychologist	OH
DR. ADELAIDA FERNANDEZ (M.D.)	P S Y C H I A T R Y	OH
BONETTA LOU COULTER (APRN-CNS)	Certified Clinical Nurse Specialist (Cns)	OH
DR. LAUREN J. FERIA (PSY.D.)	Clinical Psychologist	OH
MIRELA CRISAN	Family Practice	OH
ROBERT E TAYLOR (M.D.)	-	OH
DR. BARBARA ZARA (MD)	-	OH
VIKRAM VAKA (M.D.)	-	MD
DR. JONATHAN W SIRKIN (MD)	-	OH

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?

The registry entry for Unknown Individual shows NPI 1356450340.

What does inactive NPI status mean for Unknown Individual?

Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.

What does the directory say Unknown Individual does?

Insurance directories may phrase it differently, but here Unknown Individual maps to Psychiatry Physician. Clinical services aligned with this taxonomy classification.

Which community is linked to Unknown Individual?

Unknown Individual shows a connection to Bowling Green, Ohio in registry-derived data.

Can I verify credentials using only NPI?

NPI confirms identity in the directory; licensure and board certification require separate checks.