Unknown Individual – Nephrology Physician, NPI 1124197744

Unknown Individual is a healthcare provider. based in Charlottesville, Virginia. specializing in Nephrology Physician. They hold a License No. 0101029478 (VA). The NPI Number for Unknown Individual is 1124197744

Main info

Organization
Inactive
53 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1124197744
Phone
Not provided
Address
500 RAY C HUNT DR
Deactivation Date
9 November 2021

Doctor Profile

Medical School Name
UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Secondary Phone
4349245125
Graduation Year
1973 (53 years ago)
PAC ID
9335033752
Group Practice PAC ID
4880590728
Professional Enrollment ID
I20040209000419
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

  • 500 RAY C HUNT DR

    CHARLOTTESVILLE, VA 229032981

    Phone:

    Type: Mailing

  • Lee Street, Jefferson Park Avenue, Starr Hill, Charlottesville, Virginia, 22903, United States

    CHARLOTTESVILLE, VA 229080001

    Phone: (434) 924-0000

    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 22903)

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Provider's Procedures

Unknown Individual performs procedures in Nephrology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NEPHROLOGYVA90935Hemodialysis procedure with one physician evaluation323117

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: 4880590728View full group profile

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1124197744 if you need a stable reference for Unknown Individual.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Nephrology Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Charlottesville, Virginia because that is what the record indicates for Unknown Individual.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1124197744. Always confirm identity and privileges with the practice and licensing boards.

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