Unknown Individual – Pain Medicine (Psychiatry & Neurology) Physician, NPI 1306949912

Unknown Individual is a healthcare provider. based in Virginia beach, Virginia. specializing in Pain Medicine (Psychiatry & Neurology) Physician. They hold a License No. 0101032227 (VA). The NPI Number for Unknown Individual is 1306949912

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1306949912
Phone
(757) 425-5050
Address
1630 DONNA DRIVE
Deactivation Date
2 November 2022
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

  • 1630, Donna Drive, Laurel Manor, Atlantic Park, Virginia Beach, Virginia, 23451, United States

    SUTIE 102

    VIRGINIA BEACH, VA 234516188

    Phone: (757) 425-5050

    Fax: (757) 425-1389

    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 23451)

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Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1306949912.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Pain Medicine (Psychiatry & Neurology) Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Virginia Beach, Virginia?
If you are local to Virginia Beach, Virginia, Unknown Individual may be relevant to your search.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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