Unknown Individual – Pediatrics Physician, NPI 1245396662

Unknown Individual is a healthcare provider. based in Roseburg, Oregon. specializing in Pediatrics Physician. They hold a License No. MD00018578 (WA). The NPI Number for Unknown Individual is 1245396662

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1245396662
Phone
(541) 672-9596
Address
150 KENNETH FORD DRIVE
Deactivation Date
21 February 2024
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

  • Kenneth Ford Drive, Roseburg, Douglas County, Oregon, 97470, United States

    ROSEBURG, OR 974701042

    Phone: (541) 672-9596

    Fax: (541) 464-3519

    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.

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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 97470)

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Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1245396662; it appears in the national provider directory.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What kind of provider is Unknown Individual?
The page reflects Pediatrics Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Roseburg, Oregon for Unknown Individual; expand the address list for detail.
What if Roseburg, Oregon seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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