Unknown Individual – Family Medicine Physician, NPI 1801454509
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
940, Johnson Road, Jackson County, Ohio, 45640, United States
JACKSON, OH 456409622
Phone: (740) 464-9777
Type: Mailing
Southern Ohio Medical Center, 1805, 27th Street, Portsmouth, Scioto County, Ohio, 45662, United States
PORTSMOUTH, OH 456622640
Phone: (740) 356-3800
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $296.
Total Amount is formed as General ($296) + Research ($0) + Ownership ($0) = $296.
Last reported payment date: 2023-03-06 • Largest payer in this snapshot: ITI, Inc. ($112).
Total Amount
$296
General + Research + Ownership
Payments
3
Total payment records
General Amount
$296
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ITI, Inc. | $112 |
| ABBVIE INC. | $93 |
| Axsome Therapeutics, Inc. | $91 |
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 45640)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OH |
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