Unknown Individual – Family Medicine Physician, NPI 1700803780

Unknown Individual is a healthcare provider. based in Franklin, Ohio. specializing in Family Medicine Physician. They hold a License No. 35061803 (OH). The NPI Number for Unknown Individual is 1700803780

Main info

Organization
Inactive
36 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1700803780
Phone
(937) 746-3088
Address
333 CONOVER DR
Deactivation Date
9 January 2025

Doctor Profile

Medical School Name
WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Secondary Phone
9377463088
Graduation Year
1990 (36 years ago)
PAC ID
9436274875
Group Practice PAC ID
5991820334
Professional Enrollment ID
I20100913000200

Contacts

Secure Messaging
gbedel162621@direct.ketteringhealth.org
FHIR Endpoint
https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • 333, Conover Drive, Franklin, Warren County, Ohio, 45005, United States

    SUITE E

    FRANKLIN, OH 450051900

    Phone: (937) 746-3088

    Fax: (937) 746-8752

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $244.

Total Amount is formed as General ($244) + Research ($0) + Ownership ($0) = $244.

Last reported payment date: 2024-05-30 • Largest payer in this snapshot: Amgen Inc. ($125).

Total Amount

$244

General + Research + Ownership

Payments

2

Total payment records

General Amount

$244

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-30

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Amgen Inc.$125
PFIZER INC.$119
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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes272123$0
99213Established patient office or other outpatient visit, 20-29 minutes12089$0
90686Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage5252$0
G0008Administration of influenza virus vaccine5252$0
36415Insertion of needle into vein for collection of blood sample4848$0
View full utilization report →

Insurance plans in this area (ZIP 45005)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEOH90670Pneumococcal vaccine for injection into muscle1717

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: 5991820334View full group profile
NameSpecialtyState
-OH

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1700803780.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What kind of provider is Unknown Individual?
The page reflects Family Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Franklin, Ohio because that is what the record indicates for Unknown Individual.
What if Franklin, Ohio seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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