Unknown Individual – Medical Physician Assistant, NPI 1124208889

Unknown Individual is a healthcare provider. based in Marion, Ohio. specializing in Medical Physician Assistant. They hold a License No. 50001918 (OH). The NPI Number for Unknown Individual is 1124208889

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1124208889
Phone
(419) 674-1645
Address
941 FAIRWOOD AVE
Deactivation Date
27 October 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

  • 941, Fairwood Avenue, Marion, Marion County, Ohio, 43302, United States

    MARION, OH 433021873

    Phone: (419) 674-1645

    Type: Mailing

  • 1203, Delaware Avenue, Marion, Marion Township, Marion County, Ohio, 43302, United States

    MARION, OH 433026419

    Phone: (740) 223-8089

    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.

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.

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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 43302)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1124208889.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Medical Physician Assistant is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Marion, Ohio 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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