Unknown Individual – Family Medicine Physician, NPI 1902870975

Unknown Individual is a healthcare provider. based in Williston, Vermont. specializing in Family Medicine Physician. They hold a License No. 042-0009288 (VT). The NPI Number for Unknown Individual is 1902870975

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1902870975
Phone
(802) 288-1145
Address
600 BLAIR PARK RD
Deactivation Date
20 February 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

  • 600, Blair Park Road, Tafts Corner, Williston, Chittenden County, Vermont, 05495, United States

    SUITE 190

    WILLISTON, VT 054957586

    Phone: (802) 288-1145

    Fax: (802) 872-0282

    Type: Mailing

  • Long Trail Physical Therapy, 789, Pine Street, South end, Burlington, Chittenden County, Vermont, 05491, United States

    BURLINGTON, VT 054014933

    Phone: (802) 864-0693

    Fax: (802) 860-6613

    Type: Location

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 05495)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1902870975.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Williston, Vermont for Unknown Individual; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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