Unknown Individual – Pediatrics Physician, NPI 1194715565

Unknown Individual is a healthcare provider. based in South bend, Indiana. specializing in Pediatrics Physician. They hold a License No. 01034828A (IN). The NPI Number for Unknown Individual is 1194715565

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1194715565
Phone
(574) 233-7337
Address
211 N EDDY ST
Deactivation Date
28 August 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

  • 211, North Eddy Street, South Bend, Saint Joseph County, Indiana, 46617, United States

    SOUTH BEND, IN 466172808

    Phone: (574) 233-7337

    Fax: (574) 239-1561

    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 46617)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1194715565.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Pediatrics Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes South Bend, Indiana for Unknown Individual; expand the address list for detail.
What if South Bend, Indiana seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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