Unknown Individual – Family Nurse Practitioner, NPI 1154749919

Unknown Individual is a healthcare provider. based in Drexel hill, Pennsylvania. specializing in Family Nurse Practitioner. They hold a License No. SP013744 (PA). The NPI Number for Unknown Individual is 1154749919

Main info

Organization
Inactive
13 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1154749919
Phone
(267) 971-3552
Address
4006 MARSHALL RD
Deactivation Date
1 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6106260940
Graduation Year
2013 (13 years ago)
PAC ID
5294959078
Group Practice PAC ID
8123929114
Professional Enrollment ID
I20140618000061
Data current as of
20 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

  • 4006 MARSHALL RD

    DREXEL HILL, PA 190263412

    Phone: (267) 971-3552

    Type: Mailing

  • 731 W CYPRESS ST

    KENNETT SQUARE, PA 193482419

    Phone: (610) 444-7550

    Fax: (610) 444-6407

    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.

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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 19026)

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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: 8123929114View full group profile

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1154749919 for Unknown Individual.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Family Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Drexel Hill, Pennsylvania. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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