Unknown Individual – Family Medicine Physician, NPI 1629075320

Family Medicine Physician

Unknown Individual is a healthcare provider. based in Greenville, Ohio. specializing in Family Medicine Physician. They hold a License No. 35036156 (OH). The NPI Number for Unknown Individual is 1629075320

Main info

Organization

Inactive

53 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1629075320

Phone

(937) 569-6937

Address

835 SWEITZER ST

Deactivation Date

9 May 2022

Doctor Profile

Medical School Name

OHIO STATE UNIVERSITY COLLEGE OF MEDICINE

Secondary Phone

9379687416

Graduation Year

1973 (53 years ago)

PAC ID

0648266759

Group Practice PAC ID

3476695354

Professional Enrollment ID

I20040423000446

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

Wayne Healthcare, 835, Sweitzer Street, Greenville, Darke County, Ohio, 45331, United States
GREENVILLE, OH 453311077
Phone: (937) 569-6937
Fax: (937) 547-5789
Type: Mailing
622, East Elm Street, Union City, Darke County, Ohio, 45390, United States
UNION CITY, OH 453901722
Phone: (937) 968-7416
Type: Location
810 S 6th St
Monticello, IN 479608201
Phone: (419) 304-9450
Fax: (419) 862-3424
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 45331)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
FAMILY MEDICINE	IN	81002	Urinalysis, manual test	31	24
FAMILY MEDICINE	IN	90670	Pneumococcal vaccine for injection into muscle	14	14

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: 3476695354View full group profile

Name	Specialty	State
DR. KARA SUZANNE SCHULTZ (M.D.)	General Surgery	OH
MS. LESLIE S ACTON (FNP-C)	Nurse Practitioner	OH
DR. PATRICK A KARR (DO)	O B S T E T R I C S/ G Y N E C O L O G Y	OH
STEPHANIE N BUCHANAN	General Surgery	OH
DR. PETER W LACHIEWICZ (DO)	-	OH
BRANDON JAMES BEYKE (PA)	Physician Assistant	OH
DR. ALISHA DAWN REISS (M.D.)	General Surgery	OH
DR. JOHN A DUTRO (MD)	-	OH
BRIAN R DULIN (MD)	Cardiovascular Disease (Cardiology)	TN
MRS. ALAINE C. KIRBY (APRN)	Nurse Practitioner	OH

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?

NPI 1629075320 is assigned to Unknown Individual under the national enumeration system.

Should I trust care from Unknown Individual if status is inactive?

An inactive NPI does not by itself prove someone stopped practicing — check other sources.

Does Unknown Individual list a primary specialty?

If you are matching referrals, note Family Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.

Does Unknown Individual practice in Ohio?

You will see Greenville, Ohio on file for Unknown Individual alongside any extra practice locations.

Is Unknown Individual a real provider?

This page reflects official NPPES data for NPI 1629075320. Always confirm identity and privileges with the practice and licensing boards.

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