Unknown Individual – Obstetrics & Gynecology Physician, NPI 1700868841

Unknown Individual is a healthcare provider. based in Canton, Ohio. specializing in Obstetrics & Gynecology Physician. They hold a License No. 35049267D (OH). The NPI Number for Unknown Individual is 1700868841

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1700868841
Phone
(330) 452-9460
Address
3120 PARKWAY ST NW
Deactivation Date
22 May 2024

Doctor Profile

Medical School Name
HOWARD UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
3304529460
Graduation Year
1982 (44 years ago)
PAC ID
9931098134
Group Practice PAC ID
2365419157
Professional Enrollment ID
I20040315000669
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

  • 3120, Parkway Street Northwest, Lakeview Terrace, Meyers Lake, Stark County, Ohio, 44708, United States

    SUITE A

    CANTON, OH 447083981

    Phone: (330) 452-9460

    Fax: (330) 452-9520

    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 19 Open Payments records for all available years, with a total value of $555.

Total Amount is formed as General ($555) + Research ($0) + Ownership ($0) = $555.

Last reported payment date: 2024-03-05 • Largest payer in this snapshot: Aspira Women's Health Inc ($145).

Total Amount

$555

General + Research + Ownership

Payments

19

Total payment records

General Amount

$555

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-05

Latest reported date

Top Companies

Largest payers in this snapshot

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
99213Established patient office or other outpatient visit, 20-29 minutes5621$0
81002Urinalysis, manual test3834$0
G0101Cervical or vaginal cancer screening; pelvic and clinical breast examination2020$0
View full utilization report →

Insurance plans in this area (ZIP 44708)

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Provider's Procedures

Unknown Individual performs procedures in Obstetrics & Gynecology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OBSTETRICS/GYNECOLOGYOH76830Ultrasound pelvis through vagina3229
OBSTETRICS/GYNECOLOGYOH81002Urinalysis, manual test6764

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: 2365419157View full group profile

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1700868841.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Obstetrics & Gynecology Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Canton, Ohio in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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