Unknown Individual – Internal Medicine Physician, NPI 1801888276

Unknown Individual is a healthcare provider. based in Centralia, Illinois. specializing in Internal Medicine Physician. They hold a License No. 3640120 (IL). The NPI Number for Unknown Individual is 1801888276

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1801888276
Phone
(618) 532-6330
Address
1050 M L KING DR
Deactivation Date
17 April 2024
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

  • 1050, M L King Drive, Centralia, Marion County, Illinois, 62801, United States

    SUITE 104

    CENTRALIA, IL 628013060

    Phone: (618) 532-6330

    Fax: (618) 532-7227

    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)

CMS reports 2 Open Payments records for all available years, with a total value of $138.

Total Amount is formed as General ($138) + Research ($0) + Ownership ($0) = $138.

Last reported payment date: 2024-11-02 • Largest payer in this snapshot: Boston Scientific Corporation ($138).

Total Amount

$138

General + Research + Ownership

Payments

2

Total payment records

General Amount

$138

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-02

Latest reported date

Top Companies

Largest payers in this snapshot

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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 62801)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1801888276.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Centralia, Illinois.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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