Unknown Individual – Specialist, NPI 1104828417

Unknown Individual is a healthcare provider. based in Toledo, Ohio. specializing in Specialist. They hold a License No. 35020439 (OH). The NPI Number for Unknown Individual is 1104828417

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1104828417
Phone
(419) 824-5067
Address
5923 RENAISSANCE PLACE
Deactivation Date
30 January 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

Provider Addresses for Unknown Individual

  • 5923 RENAISSANCE PLACE

    TOLEDO, OH 43623

    Phone: (419) 824-5067

    Fax: (419) 824-5457

    Type: Location

  • Winslow Road, Whitehouse, Lucas County, Ohio, 43571, United States

    WHITEHOUSE, OH 43571

    Phone: (419) 877-9171

    Type: Mailing

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.

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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 43623)

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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 1104828417.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
How should patients interpret Unknown Individual's specialty?
The extract shows Other Service Providers for Unknown Individual. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Toledo, Ohio. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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