Unknown Individual – Family Medicine Physician, NPI 1639138548

Unknown Individual is a healthcare provider. based in Riztville, Washington. specializing in Family Medicine Physician. They hold a License No. MD00026120 (WA). The NPI Number for Unknown Individual is 1639138548

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1639138548
Phone
(509) 659-1200
Address
920 S ADAMS
Deactivation Date
26 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5096591200
Graduation Year
1977 (49 years ago)
PAC ID
7517858343
Group Practice PAC ID
8022906122
Professional Enrollment ID
I20140225001669
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 920 S ADAMS

    RIZTVILLE, WA 991692227

    Phone: (509) 659-1200

    Fax: (509) 659-1200

    Type: Location

  • East Adams Rural Healthcare, 903, South Adams Street, Ritzville, Adams County, Washington, 99169, United States

    RITZVILLE, WA 991692227

    Phone: (509) 659-1200

    Fax: (509) 659-1252

    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 99169)

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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: 8022906122View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)WA
Physician AssistantWA
Family PracticeWA
Nurse PractitionerGA
Nurse PractitionerWA
Nurse PractitionerWA
Physician AssistantWA
Physician AssistantWA

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1639138548 on file in the registry.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Riztville, Washington as the reference point for Unknown Individual, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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