Unknown Individual – Neurology Physician, NPI 1023251139

Unknown Individual is a healthcare provider. based in Tappahannock, Virginia. specializing in Neurology Physician. They hold a License No. NH4815 (NH). The NPI Number for Unknown Individual is 1023251139

Main info

Organization
Inactive
63 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1023251139
Phone
(804) 443-6143
Address
300 MT CLEMENT PARK
Deactivation Date
2 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2167787800
Graduation Year
1963 (63 years ago)
PAC ID
5395789853
Group Practice PAC ID
8628982949
Professional Enrollment ID
I20200428001198
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 300 MT CLEMENT PARK

    SUITE D

    TAPPAHANNOCK, VA 225605098

    Phone: (804) 443-6143

    Fax: (804) 443-6149

    Type: Location

  • 856, J Clyde Morris Boulevard, City Center, Newport News, Newport News City, Virginia, 23601, United States

    SUITE A

    NEWPORT NEWS, VA 236011318

    Phone:

    Type: Mailing

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 22560)

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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: 8628982949View full group profile
NameSpecialtyState
-OH
-OH
Plastic And Reconstructive Surgery, Maxillofacial SurgeryOH
Cardiovascular Disease (Cardiology)OH
Emergency MedicineIN
Nurse PractitionerOH
-OH
Cardiovascular Disease (Cardiology), Internal MedicineOH
-OH
General SurgeryOH

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1023251139 — the number used across U.S. healthcare to identify this provider.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Neurology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Tappahannock?
Public fields place Unknown Individual around Tappahannock, Virginia. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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