Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1023003795

Certified Registered Nurse Anesthetist

Unknown Individual is a healthcare provider. based in Suffolk, Virginia. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 0024077570 (VA). The NPI Number for Unknown Individual is 1023003795

Main info

Organization

Inactive

44 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1023003795

Phone

(757) 934-9334

Address

PO BOX 877

Deactivation Date

30 April 2026

Doctor Profile

Medical School Name

OTHER

Secondary Phone

7573126151

Graduation Year

1982 (44 years ago)

PAC ID

1456304906

Group Practice PAC ID

1456347871

Professional Enrollment ID

I20050224000923

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

PO BOX 877
SUFFOLK, VA 234390877
Phone: (757) 934-9334
Fax: (757) 923-9648
Type: Mailing
2000, Meade Parkway, Palmyra, Suffolk, Virginia, 23434, United States
SUFFOLK, VA 234344259
Phone: (757) 934-9334
Fax: (757) 923-9648
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 23439)

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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: 1456347871View full group profile

Name	Specialty	State
ROSS A. MALLEY (MD)	-	GA
DR. TODD BATTEAU (CRNA, DNP)	-	VA
JASON FIFE (RN, CRNA)	-	PA
THOMAS J GREGUS (MD)	-	GA
MS. MARY BETH DARDEN (C.R.N.A.)	-	VA
JOHN D GOBER (MD)	-	GA
ROBERT F QUAST (MD)	-	GA
LAUREN SUSZAN (CRNA)	-	VA

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?

The federal identifier for Unknown Individual is NPI 1023003795.

Is Unknown Individual's inactive status permanent?

An inactive NPI does not by itself prove someone stopped practicing — check other sources.

Does Unknown Individual list a primary specialty?

If you are matching referrals, note Certified Registered Nurse Anesthetist for Unknown Individual. Clinical services aligned with this taxonomy classification.

What location metadata exists for Unknown Individual?

The page summarizes Suffolk, Virginia for Unknown Individual; expand the address list for detail.

Is Unknown Individual a real provider?

This page reflects official NPPES data for NPI 1023003795. Always confirm identity and privileges with the practice and licensing boards.