Unknown Individual – Obstetrics & Gynecology Physician, NPI 1497830855

Unknown Individual is a healthcare provider. based in Moraine, Ohio. specializing in Obstetrics & Gynecology Physician. They hold a License No. 31975 (TN). The NPI Number for Unknown Individual is 1497830855

Main info

Organization
Inactive
31 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1497830855
Phone
(937) 991-3188
Address
3170 KETTERING BLVD BLDG B2ND
Deactivation Date
6 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9374351445
Graduation Year
1995 (31 years ago)
PAC ID
5890746267
Group Practice PAC ID
5597708594
Professional Enrollment ID
I20180725000564

Contacts

Secure Messaging
tthomas637426@direct.vumc.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:0State licenses:2Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • 3170 KETTERING BLVD BLDG B2ND

    MORAINE, OH 454391924

    Phone: (937) 991-3188

    Fax: (937) 223-9811

    Type: Mailing

  • East Emmett Street, Battle Creek, Calhoun County, Michigan, 49016, United States

    BATTLE CREEK, MI 49037

    Phone: (269) 965-8866

    Type: Location

  • 181 Emmett St W

    Battle Creek, MI 49037

    Phone: (269) 965-8866

    Type: Location

  • 105 Sugar Camp Cir Ste 200

    Oakwood, OH 454091979

    Phone: (937) 208-4100

    Fax: (937) 208-6260

    Type: Location

  • 3841 GREEN HILLS VILLAGE DR STE 200

    NASHVILLE, TN 372152691

    Phone:

    Type: Mailing

  • 3601 THE VANDERBILT CLINIC

    NASHVILLE, TN 372320001

    Phone: (615) 322-3000

    Type: Location

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 45439)

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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: 5597708594View full group profile
NameSpecialtyState
Hand Surgery, Orthopedic SurgeryOH
Physician AssistantOH
-OH
Cardiovascular Disease (Cardiology)OH
-OH
Physician AssistantOH
Thoracic SurgeryPA
Physician AssistantOH
Nurse PractitionerOH
Physician AssistantOH

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 1497830855.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Moraine, Ohio?
If you are local to Moraine, Ohio, Unknown Individual may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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