Unknown Individual – Family Medicine Physician, NPI 1891788626

Unknown Individual is a healthcare provider. based in Springfield, Ohio. specializing in Family Medicine Physician. They hold a License No. 35029854A (OH). The NPI Number for Unknown Individual is 1891788626

Main info

Organization
Inactive
60 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1891788626
Phone
(937) 399-6650
Address
2701 MOOREFIELD RD
Deactivation Date
23 August 2023

Doctor Profile

Medical School Name
VIRGINIA COMMONWEALTH UNIVERSITY, SCHOOL OF MEDICINE
Secondary Phone
9373996650
Graduation Year
1966 (60 years ago)
PAC ID
3971593146
Group Practice PAC ID
8820088149
Professional Enrollment ID
I20071207000641
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

Provider Addresses for Unknown Individual

  • 2701 MOOREFIELD RD

    SPRINGFIELD, OH 455028207

    Phone: (937) 399-6650

    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)

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 45502)

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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: 8820088149View full group profile
NameSpecialtyState
Family PracticeOH
Physician AssistantOH

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1891788626?
NPI 1891788626 belongs to Unknown Individual; compare other details if you need extra assurance.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Springfield?
Unknown Individual currently maps to Springfield, Ohio in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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