Unknown Individual – Optometrist, NPI 1083608061

Unknown Individual is a healthcare provider. based in Fredericksburg, Virginia. specializing in Optometrist. They hold a License No. 0618000420 (VA). The NPI Number for Unknown Individual is 1083608061

Main info

Organization
Inactive
59 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1083608061
Phone
(540) 371-9191
Address
1823 CHARLES ST
Deactivation Date
7 September 2022

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
5403719191
Graduation Year
1967 (59 years ago)
PAC ID
4082727409
Professional Enrollment ID
I20101130000540
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

  • 1823, Charles Street, Fredericksburg, Fredericksburg City, Virginia, 22401, United States

    FREDERICKSBURG, VA 224013530

    Phone: (540) 371-9191

    Fax: (540) 373-0017

    Mailing address matches the actual address.

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 22401)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1083608061 for Unknown Individual, then check state licensing separately.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Optometrist. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Fredericksburg, Virginia in the data we show; additional addresses may exist on the full record.
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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