Unknown Individual – Nephrology Physician, NPI 1154489607

Unknown Individual is a healthcare provider. based in Traverse city, Michigan. specializing in Nephrology Physician. They hold a License No. 4301071657 (MI). The NPI Number for Unknown Individual is 1154489607

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1154489607
Phone
(231) 935-0338
Address
4062 W ROYAL DR
Deactivation Date
7 December 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

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Provider Addresses for Unknown Individual

  • Munson Dialysis Center, 4062, West Royal Drive, Garfield Township, Grand Traverse County, Michigan, 49684, United States

    TRAVERSE CITY, MI 496848965

    Phone: (231) 935-0338

    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 49684)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1154489607 — is the standard way to identify this listing.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Nephrology Physician. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Traverse City, Michigan; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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