Unknown Individual – Neurology Physician, NPI 1124097423

Unknown Individual is a healthcare provider. based in Fairhaven, Massachusetts. specializing in Neurology Physician. They hold a License No. MD12802 (RI). The NPI Number for Unknown Individual is 1124097423

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1124097423
Phone
(508) 973-2000
Address
200 MILL RD
Deactivation Date
16 June 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 200, Mill Road, Nasketucket, Fairhaven, Bristol County, Massachusetts, 02719, United States

    SUITE 180

    FAIRHAVEN, MA 027195252

    Phone: (508) 973-2000

    Fax: (508) 973-2001

    Type: Mailing

  • 534, Prospect Street, Fall River Station, Fall River, Bristol County, Massachusetts, 02720, United States

    FALL RIVER, MA 027205239

    Phone: (508) 990-0963

    Fax: (774) 206-4166

    Type: Location

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.

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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 02719)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1124097423 for Unknown Individual, then check state licensing separately.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Neurology Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Fairhaven, Massachusetts in our summary view.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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