Unknown Individual – General Practice Physician, NPI 1629052147

Unknown Individual is a healthcare provider. based in Indianapolis, Indiana. specializing in General Practice Physician. They hold a License No. 01028660 (IN). The NPI Number for Unknown Individual is 1629052147

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1629052147
Phone
Not provided
Address
5230 E STOP 11 RD
Deactivation Date
9 June 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 5230, East Stop 11 Road, Indianapolis, Indiana, 46237, United States

    SUITE 190

    INDIANAPOLIS, IN 462376398

    Phone:

    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 46237)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1629052147 if you need a stable reference for Unknown Individual.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty General Practice Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Indiana?
You will see Indianapolis, Indiana on file for Unknown Individual alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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