Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1366444887

Unknown Individual is a healthcare provider. based in Jackson, Michigan. specializing in Certified Registered Nurse Anesthetist. They hold a License No. R022543 (MD). The NPI Number for Unknown Individual is 1366444887

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1366444887
Phone
(517) 686-6440
Address
255 W MICHIGAN AVE
Deactivation Date
3 April 2025
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

  • 255, West Michigan Avenue, Jackson, Jackson County, Michigan, 49201, United States

    JACKSON, MI 492012218

    Phone: (517) 686-6440

    Type: Mailing

  • Carroll Hospital, 200, Memorial Avenue, Alto Vista, Westminster, Carroll County, Maryland, 21157, United States

    WESTMINSTER, MD 211575726

    Phone: (410) 871-6696

    Fax: (410) 871-6490

    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.

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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.

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 49201)

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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 1366444887 for Unknown Individual, then check state licensing separately.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Jackson, Michigan as a primary anchor for Unknown Individual unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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