Unknown Individual – Procedural Dermatology Physician, NPI 1609851609

Unknown Individual is a healthcare provider. based in Fredericksburg, Virginia. specializing in Procedural Dermatology Physician. They hold a License No. 0101021703 (VA). The NPI Number for Unknown Individual is 1609851609

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1609851609
Phone
(540) 371-3115
Address
1300 THORNTON ST
Deactivation Date
7 May 2026
Data current as of
3 June 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

  • 1300, Thornton Street, Maryes Heights, Fredericksburg, Fredericksburg City, Virginia, 22401, United States

    FREDERICKSBURG, VA 224014654

    Phone: (540) 371-3115

    Fax: (540) 372-9860

    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)

CMS reports 2 Open Payments records for all available years, with a total value of $45.

Total Amount is formed as General ($45) + Research ($0) + Ownership ($0) = $45.

Last reported payment date: 2024-04-22 • Largest payer in this snapshot: SANOFI PASTEUR INC. ($26).

Total Amount

$45

General + Research + Ownership

Payments

2

Total payment records

General Amount

$45

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-22

Latest reported date

Top Companies

Largest payers in this snapshot

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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 22401)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1609851609 — is the standard way to identify this listing.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Procedural Dermatology Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Fredericksburg, Virginia in the data we show; additional addresses may exist on the full record.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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