Unknown Individual – Physical Therapist, NPI 1619956729

Unknown Individual is a healthcare provider. based in South portland, Maine. specializing in Physical Therapist. They hold a License No. PT2286 (ME). The NPI Number for Unknown Individual is 1619956729

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1619956729
Phone
(207) 780-8860
Address
100 FODEN RD, EAST
Deactivation Date
15 November 2021
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

Provider Addresses for Unknown Individual

  • 100 FODEN RD, EAST

    SUITE 205

    SOUTH PORTLAND, ME 04106

    Phone: (207) 780-8860

    Fax: (207) 523-8584

    Type: Location

  • 100, Gannett Drive, South Portland, Cumberland County, Maine, 04106, United States

    SUITE C

    SOUTH PORTLAND, ME 04106

    Phone: (207) 828-0361

    Fax: (207) 874-1483

    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.

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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.

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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 04106)

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Provider's Procedures

Unknown Individual performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYME97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes28720

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1619956729 when you need to reference Unknown Individual in forms, claims, or directories.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Physical Therapist for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes South Portland, Maine for Unknown Individual; expand the address list for detail.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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