Unknown Individual – Family Medicine Physician, NPI 1063409084

Unknown Individual is a healthcare provider. based in Front royal, Virginia. specializing in Family Medicine Physician. They hold a License No. 0101017520 (VA). The NPI Number for Unknown Individual is 1063409084

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1063409084
Phone
(540) 636-2931
Address
209 W CRISER RD
Deactivation Date
3 June 2021
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

  • 209, West Criser Road, Viscose City, Front Royal, Warren County, Virginia, 22630, United States

    SUITE 100

    FRONT ROYAL, VA 226302360

    Phone: (540) 636-2931

    Fax: (540) 636-2933

    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 22630)

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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 1063409084; it appears in the national provider directory.
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 kind of provider is Unknown Individual?
The page reflects Family Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Virginia?
You will see Front Royal, Virginia on file for Unknown Individual alongside any extra practice locations.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1063409084. Always confirm identity and privileges with the practice and licensing boards.

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