Unknown Individual – Emergency Medicine Physician, NPI 1730131921

Unknown Individual is a healthcare provider. based in Kettering, Ohio. specializing in Emergency Medicine Physician. They hold a License No. 35071744 (OH). The NPI Number for Unknown Individual is 1730131921

Main info

Organization
Inactive
34 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1730131921
Phone
(800) 875-0136
Address
4750 HEMPSTEAD STATION DR
Deactivation Date
4 February 2022

Doctor Profile

Medical School Name
WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Secondary Phone
6145665000
Graduation Year
1992 (34 years ago)
PAC ID
7315930955
Group Practice PAC ID
7810985686
Professional Enrollment ID
I20040614000562
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

  • 4750, Hempstead Station Drive, Kettering, Montgomery County, Ohio, 45429, United States

    KETTERING, OH 454295164

    Phone: (800) 875-0136

    Fax: (937) 619-4231

    Type: Mailing

  • Memorial Hospital, 500, London Avenue, Marysville Historic District, Marysville, Union County, Ohio, 43040, United States

    MARYSVILLE, OH 430405512

    Phone: (937) 644-6115

    Fax: (937) 578-2812

    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 45429)

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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: 7810985686View full group profile
NameSpecialtyState
DR. KENNETH ALLEN WRITESEL (D.O.)
-FL
MICHAEL JOSEPH HARDMAN (M.D.)
Hospitalist, Internal MedicineOH
WILLIAM LEE MEYER (M.D.)
Internal MedicineOH
KATHRYN J CALDWELL (PA)
Physician AssistantOH
KAREN SUE ROSE (CNP)
-OH
YEVGENY GILILOV
Internal MedicineNY
MICHAEL COMIANOS (D.O.)
Internal MedicineOH
DR. KUDA KUNAKA (M.D.)
-MI
GHARANAI ABDUL PAYIND (MD)
Internal MedicineOH
DR. MICHAEL K HUANG (MD)
-OH

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1730131921 when you need to reference Unknown Individual in forms, claims, or directories.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Emergency Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Kettering, Ohio for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1730131921. Always confirm identity and privileges with the practice and licensing boards.

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