Unknown Individual – Optometrist, NPI 1205815065

Unknown Individual is a healthcare provider. based in New carlisle, Ohio. specializing in Optometrist. They hold a License No. 2703/T1047 (OH). The NPI Number for Unknown Individual is 1205815065

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1205815065
Phone
(937) 845-0751
Address
102 E LAKE AVE
Deactivation Date
17 January 2022
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

  • 102, East Lake Avenue, New Carlisle, Clark County, Ohio, 45344, United States

    NEW CARLISLE, OH 453441417

    Phone: (937) 845-0751

    Fax: (937) 845-2931

    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 45344)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1205815065 when you need to reference Unknown Individual in forms, claims, or directories.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Optometrist. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface New Carlisle, Ohio for Unknown Individual based on available NPPES addresses.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1205815065. Always confirm identity and privileges with the practice and licensing boards.

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