Unknown Individual – Family Medicine Physician, NPI 1629042353

Unknown Individual is a healthcare provider. based in Wilmington, Ohio. specializing in Family Medicine Physician. They hold a License No. 35-031624 (OH). The NPI Number for Unknown Individual is 1629042353

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1629042353
Phone
(937) 382-0918
Address
222 W MAIN ST
Deactivation Date
7 August 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

  • 222, West Main Street, Wilmington Commercial Historic District, Wilmington, Clinton County, Ohio, 45177, United States

    WILMINGTON, OH 451772241

    Phone: (937) 382-0918

    Fax: (937) 383-1123

    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 45177)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1629042353 as the unique 10-digit identifier.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Wilmington, Ohio as the reference point for Unknown Individual, then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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