Unknown Individual – Physical Therapist, NPI 1104291012

Unknown Individual is a healthcare provider. based in Nanticoke, Pennsylvania. specializing in Physical Therapist. They hold a License No. PT003397L (PA). The NPI Number for Unknown Individual is 1104291012

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1104291012
Phone
Not provided
Address
147 OLD NEWPORT ST
Deactivation Date
31 July 2024
Data current as of
20 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

  • 147 OLD NEWPORT ST

    NANTICOKE, PA 186341327

    Phone:

    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 18634)

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Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1104291012 in the public NPI dataset.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Physical Therapist. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Nanticoke, Pennsylvania; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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