Unknown Individual – Hospice and Palliative Medicine (Internal Medicine) Physician, NPI 1396840294

Unknown Individual is a healthcare provider. based in Dayton, Ohio. specializing in Hospice and Palliative Medicine (Internal Medicine) Physician. They hold a License No. 35.87695 (OH). The NPI Number for Unknown Individual is 1396840294

Main info

Organization
Inactive
24 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1396840294
Phone
(937) 256-4490
Address
324 WILMINGTON AVE
Deactivation Date
21 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9377651363
Graduation Year
2002 (24 years ago)
PAC ID
9032258215
Group Practice PAC ID
1456648989
Professional Enrollment ID
I20091201000353
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Wilmington Avenue, Dayton, Montgomery County, Ohio, 45420:45440, United States

    HOSPICE OF DAYTON

    DAYTON, OH 454201890

    Phone: (937) 256-4490

    Fax: (937) 258-5516

    Type: Location

  • 1131, Windsong Trail, Fairborn, Greene County, Ohio, 45324, United States

    FAIRBORN, OH 453248745

    Phone: (937) 545-5931

    Type: Mailing

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 $14.

Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.

Last reported payment date: 2023-09-05 • Largest payer in this snapshot: Incyte Corporation ($14).

Total Amount

$14

General + Research + Ownership

Payments

1

Total payment records

General Amount

$14

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-05

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Incyte Corporation$14
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 45420)

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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: 1456648989View 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 1396840294 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.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Hospice and Palliative Medicine (Internal Medicine) Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Dayton, Ohio in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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