Unknown Individual – Family Medicine Physician, NPI 1861479446

Unknown Individual is a healthcare provider. based in Beverly, Massachusetts. specializing in Family Medicine Physician. They hold a License No. 75709 (MA). The NPI Number for Unknown Individual is 1861479446

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1861479446
Phone
(978) 922-7074
Address
100 CUMMINGS CTR
Deactivation Date
31 May 2023
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

  • 100 Cummings Center, Cummings Center, Rial Side, Beverly, Essex County, Massachusetts, 01915-4202, United States

    109D

    BEVERLY, MA 019156115

    Phone: (978) 922-7074

    Fax: (978) 922-7484

    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 01915)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1861479446.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Beverly, Massachusetts; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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