Unknown Individual – Child & Adolescent Psychiatry Physician, NPI 1902829492

Child & Adolescent Psychiatry Physician

Unknown Individual is a healthcare provider. based in Columbus, Ohio. specializing in Child & Adolescent Psychiatry Physician. They hold a License No. 026585 (OH). The NPI Number for Unknown Individual is 1902829492

Main info

Organization

Inactive

63 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1902829492

Phone

(614) 293-2594

Address

700 ACKERMAN RD

Deactivation Date

19 June 2025

Doctor Profile

Medical School Name

OHIO STATE UNIVERSITY COLLEGE OF MEDICINE

Secondary Phone

6146856701

Graduation Year

1963 (63 years ago)

PAC ID

3971595612

Group Practice PAC ID

5698796456

Professional Enrollment ID

I20040401000707

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

700, Ackerman Road, Columbus, Sharon, Franklin, Ohio, 43202, United States
SUITE 570
COLUMBUS, OH 432021559
Phone: (614) 293-2594
Type: Mailing
McCampbell Hall, 1581, Dodd Drive, University District District 4, Columbus, Franklin, Ohio, 43210, United States
COLUMBUS, OH 432101257
Phone: (614) 292-9780
Fax: (614) 688-5705
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 43202)

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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: 5698796456View full group profile

Name	Specialty	State
DR. VANESSA RODRIGUEZ (PHD BCBA-D)	P S Y C H I A T R Y	OH
CRAIG EDWARD WILLIAMS (MD)	P S Y C H I A T R Y	OH
ERIN A. HARRIS (LISW)	Clinical Social Worker	OH
KANDAMURUGU MANICKAM (MD)	Internal Medicine, Pediatric Medicine	OH

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?

You can confirm Unknown Individual with NPI 1902829492; it appears in the national provider directory.

How do I interpret inactive records for Unknown Individual?

Treat inactive as a signal to verify Unknown Individual through official channels.

What field does Unknown Individual work in?

You can think of Unknown Individual as practicing within Child & Adolescent Psychiatry Physician. Clinical services aligned with this taxonomy classification.

Where is Unknown Individual's primary listing?

We display Columbus, Ohio because that is what the record indicates for Unknown Individual.

How can I contact Unknown Individual?

Phone or fax may appear on the official NPI record when supplied — verify before relying on them.