Unknown Individual – Family Medicine Physician, NPI 1558400408

Family Medicine Physician

Unknown Individual is a healthcare provider. based in Blacklick, Ohio. specializing in Family Medicine Physician. They hold a License No. 24368 (OH). The NPI Number for Unknown Individual is 1558400408

Main info

Organization

Inactive

Name

Unknown Individual

NPI

1558400408

Phone

(614) 939-0213

Address

2510 KEMPERWOOD DR

Deactivation Date

5 March 2026

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

2510 KEMPERWOOD DR
BLACKLICK, OH 430048665
Phone: (614) 939-0213
Fax: (614) 939-0213
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 43004)

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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 1558400408.

Is Unknown Individual's NPI deactivated?

The extract indicates Unknown Individual is not in an active NPI state.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.

Does Unknown Individual list a practice location?

Patients near Blacklick, Ohio may find Unknown Individual in results; validate coverage separately.

Is the information about Unknown Individual up to date?

Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."