Unknown Individual – Family Medicine Physician, NPI 1013912880

Family Medicine Physician

Unknown Individual is a healthcare provider. based in Bloomington, Indiana. specializing in Family Medicine Physician. They hold a License No. 01024358A (IN). The NPI Number for Unknown Individual is 1013912880

Main info

Organization

Inactive

Name

Unknown Individual

NPI

1013912880

Phone

(812) 333-3300

Address

421 S LANDMARK AVE

Deactivation Date

13 February 2025

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

South Landmark Avenue, Bloomington, Monroe County, Indiana, 47402, United States
BLOOMINGTON, IN 474035003
Phone: (812) 333-3300
Fax: (812) 331-3311
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 1 Open Payments records for all available years, with a total value of $30.

Total Amount is formed as General ($30) + Research ($0) + Ownership ($0) = $30.

Last reported payment date: 2024-06-08 • Largest payer in this snapshot: ABBVIE INC. ($30).

Total Amount

$30

General + Research + Ownership

Payments

Total payment records

General Amount

$30

General payments

Research Amount

Research funding

Ownership Amount

Ownership interests

Ownership Count

Ownership records

Last Payment Date

2024-06-08

Latest reported date

Top Companies

Largest payers in this snapshot

Company	Amount
ABBVIE INC.	$30

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 47403)

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Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?

Administrative and clinical systems typically use NPI 1013912880 for Unknown Individual.

What does inactive NPI status mean for Unknown Individual?

Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.

What does the directory say Unknown Individual does?

Insurance directories may phrase it differently, but here Unknown Individual maps to Family Medicine Physician. Clinical services aligned with this taxonomy classification.

What city is tied to Unknown Individual?

The directory associates Unknown Individual with Bloomington, Indiana. Check all listed addresses for suites or satellite offices.

Why is information missing for Unknown Individual?

Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.