Unknown Individual – Obstetrics & Gynecology Physician, NPI 1639270879

Unknown Individual is a healthcare provider. based in Lynchburg, Virginia. specializing in Obstetrics & Gynecology Physician. They hold a License No. 131173 (NY). The NPI Number for Unknown Individual is 1639270879

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1639270879
Phone
(434) 455-3275
Address
2402 ATHERHOLT RD
Deactivation Date
3 January 2024

Doctor Profile

Medical School Name
UNIVERSITY OF CHICAGO, PRITZKER SCHOOL OF MEDICINE
Secondary Phone
4342006401
Graduation Year
1976 (50 years ago)
PAC ID
8729098405
Group Practice PAC ID
9537060413
Professional Enrollment ID
I20140422001906
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

  • 2402, Atherholt Road, Dearington, Lynchburg, Lynchburg (city), Virginia, 24501, United States

    LYNCHBURG, VA 245012148

    Phone: (434) 455-3275

    Type: Location

  • James River Place, 1215, Jefferson Street, Downtown, Lynchburg, Virginia, 24504, United States

    APT 4W

    LYNCHBURG, VA 245041813

    Phone: (917) 696-7227

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $43.

Total Amount is formed as General ($43) + Research ($0) + Ownership ($0) = $43.

Last reported payment date: 2023-06-06 • Largest payer in this snapshot: SOBI, INC ($23).

Total Amount

$43

General + Research + Ownership

Payments

2

Total payment records

General Amount

$43

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-06-06

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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 24501)

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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: 9537060413View full group profile
NameSpecialtyState
Nurse PractitionerVA
-VA
Nurse PractitionerVA
O B S T E T R I C S/ G Y N E C O L O G YPA
O B S T E T R I C S/ G Y N E C O L O G YVA
-WV
Nurse PractitionerSC
-VA
Family PracticeVA
-VA

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1639270879.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Obstetrics & Gynecology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Lynchburg, Virginia for Unknown Individual; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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