Unknown Individual – Family Nurse Practitioner, NPI 1497748917

Unknown Individual is a healthcare provider. based in Leesburg, Virginia. specializing in Family Nurse Practitioner. They hold a License No. 0024097837 (VA). The NPI Number for Unknown Individual is 1497748917

Main info

Organization
Inactive
30 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1497748917
Phone
(703) 724-7530
Address
44055 RIVERSIDE PKWY
Deactivation Date
2 August 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7037297652
Graduation Year
1996 (30 years ago)
PAC ID
0042204828
Group Practice PAC ID
0042119661
Professional Enrollment ID
I20040413001832
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

  • 44055 RIVERSIDE PKWY

    STE 110

    LEESBURG, VA 201765179

    Phone: (703) 724-7530

    Fax: (703) 858-2870

    Type: Location

  • 17334, Troyer Road, Troyer, Monkton, Baltimore County, Maryland, 21111, United States

    BALTIMORE, MD 212971334

    Phone: (703) 443-6717

    Fax: (703) 443-8643

    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 20176)

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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: 0042119661View full group profile

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1497748917.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Leesburg, Virginia for Unknown Individual based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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