Unknown Individual – Clinical Social Worker, NPI 1053429183

Unknown Individual is a healthcare provider. based in Richmond, Virginia. specializing in Clinical Social Worker. They hold a License No. 0904003108 (VA). The NPI Number for Unknown Individual is 1053429183

Main info

Organization
Inactive
34 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1053429183
Phone
(804) 743-0960
Address
6603 IRONGATE SQ
Deactivation Date
9 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8047430960
Graduation Year
1992 (34 years ago)
PAC ID
2466439476
Group Practice PAC ID
5799762712
Professional Enrollment ID
I20040707000480
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

  • 6603 IRONGATE SQ

    RICHMOND, VA 23234

    Phone: (804) 743-0960

    Fax: (804) 743-1175

    Type: Mailing

  • 6603 IRONGATE SQUARE

    RICHMOND, VA 23234

    Phone: (804) 743-0960

    Fax: (804) 743-1175

    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 23234)

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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: 5799762712View full group profile
NameSpecialtyState
Clinical Social WorkerVA
Clinical Social WorkerVA
Clinical Social WorkerVA
Clinical Social WorkerMN
Mental Health CounselorFL
Clinical Social WorkerVA
Clinical Social WorkerVA
Mental Health CounselorGA
Clinical Social WorkerVA
-VA

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1053429183.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Clinical Social Worker in this dataset. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Richmond, Virginia may find Unknown Individual in results; validate coverage separately.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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