Unknown Individual – Internal Medicine Physician, NPI 1538150792

Unknown Individual is a healthcare provider. based in Petersburg, Virginia. specializing in Internal Medicine Physician. They hold a License No. 0101017919 (VA). The NPI Number for Unknown Individual is 1538150792

Main info

Organization
Inactive
60 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1538150792
Phone
(804) 861-8444
Address
507 S SYCAMORE ST
Deactivation Date
28 October 2022

Doctor Profile

Medical School Name
UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Secondary Phone
8048618444
Graduation Year
1966 (60 years ago)
PAC ID
8325182942
Professional Enrollment ID
I20100223000326
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

  • 507, South Sycamore Street, Heights, Petersburg, Virginia, 23803, United States

    PETERSBURG, VA 238035037

    Phone: (804) 861-8444

    Fax: (804) 862-1582

    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 23803)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEVA81002Urinalysis, manual test2924
INTERNAL MEDICINEVA93922Ultrasound study of arteries of both arms and legs1111

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 1538150792.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Internal Medicine Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Petersburg, Virginia in the data we show; additional addresses may exist on the full record.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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Unknown Individual

Internal Medicine Physician
Petersburg Post Office, 29, Franklin Street, Blandford, Petersburg, Virginia, 23803, United States
NPI: 1275503500