Unknown Individual – Obstetrics & Gynecology Physician, NPI 1861459273

Unknown Individual is a healthcare provider. based in Salem, Virginia. specializing in Obstetrics & Gynecology Physician. They hold a License No. 0101237419 (VA). The NPI Number for Unknown Individual is 1861459273

Main info

Organization
Inactive
25 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1861459273
Phone
(540) 772-3680
Address
1900 ELECTRIC RD
Deactivation Date
16 December 2021

Doctor Profile

Medical School Name
SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5407723680
Graduation Year
2001 (25 years ago)
PAC ID
0941239115
Group Practice PAC ID
6507886231
Professional Enrollment ID
I20050808000930
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

  • LewisGale Medical Center, 1900, Electric Road, Cliffview, Salem, Salem (city), Virginia, 24153, United States

    SUITE 1020

    SALEM, VA 241537474

    Phone: (540) 772-3680

    Fax: (540) 772-3679

    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 24153)

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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: 6507886231View full group profile
NameSpecialtyState
Nurse PractitionerVA
P S Y C H I A T R YVA
Nurse PractitionerVA
Physician AssistantTN
Physician AssistantVA
-VA
Family PracticeVA
Nurse PractitionerVA
Family PracticeTN
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)OH

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1861459273 for Unknown Individual, then check state licensing separately.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Salem, Virginia as a primary anchor for Unknown Individual unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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