Unknown Individual – Family Medicine Physician, NPI 1144201005

Unknown Individual is a healthcare provider. based in Brockton, Massachusetts. specializing in Family Medicine Physician. They hold a License No. 52617 (MA). The NPI Number for Unknown Individual is 1144201005

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1144201005
Phone
(508) 894-0400
Address
110 LIBERTY ST
Deactivation Date
28 January 2022
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

  • 110, Liberty Street, Marshall Corner, Brockton, Plymouth County, Massachusetts, 02357, United States

    BROCKTON, MA 023015521

    Phone: (508) 894-0400

    Fax: (508) 565-0157

    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 02301)

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Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1144201005.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Brockton, Massachusetts?
If you are local to Brockton, Massachusetts, Unknown Individual may be relevant to your search.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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