Unknown Individual – Emergency Medicine Physician, NPI 1326141672

Unknown Individual is a healthcare provider. based in Lebanon, Virginia. specializing in Emergency Medicine Physician. They hold a License No. 0101031383 (VA). The NPI Number for Unknown Individual is 1326141672

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1326141672
Phone
(276) 883-8200
Address
3600 TATE AND CARROLL STREETS
Deactivation Date
4 September 2024

Doctor Profile

Medical School Name
WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2768838000
Graduation Year
1978 (48 years ago)
PAC ID
6204885106
Group Practice PAC ID
4183991227
Professional Enrollment ID
I20080829000146
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

  • 3600 TATE AND CARROLL STREETS

    LEBANON, VA 24266

    Phone: (276) 883-8200

    Fax: (276) 889-0465

    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 24266)

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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: 4183991227View full group profile

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1326141672.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Emergency Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Lebanon, Virginia. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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