Unknown Individual – Pediatrics Physician, NPI 1902890072

Unknown Individual is a healthcare provider. based in Chesapeake, Virginia. specializing in Pediatrics Physician. They hold a License No. 0101054764 (VA). The NPI Number for Unknown Individual is 1902890072

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1902890072
Phone
(757) 668-5445
Address
817 Volvo Pkwy
Deactivation Date
2 October 2024
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

Provider Addresses for Unknown Individual

  • 817 Volvo Pkwy

    Chesapeake, VA 233202855

    Phone: (757) 668-5445

    Type: Location

  • 3960 Virginia Beach Blvd

    Virginia Beach, VA 234522449

    Phone: (757) 668-4648

    Type: Location

  • 17334, Troyer Road, Troyer, Monkton, Baltimore County, Maryland, 21111, United States

    BALTIMORE, MD 212971334

    Phone: (703) 443-6717

    Fax: (703) 443-8643

    Type: Mailing

  • 19500, Sandridge Way, Ashburn Junction, Leesburg, Loudoun County, Virginia, 20176, United States

    SUITE 110

    LEESBURG, VA 201766821

    Phone: (703) 723-7337

    Fax: (703) 723-6848

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $30.

Total Amount is formed as General ($30) + Research ($0) + Ownership ($0) = $30.

Last reported payment date: 2023-01-09 • Largest payer in this snapshot: kaleo, Inc. ($30).

Total Amount

$30

General + Research + Ownership

Payments

1

Total payment records

General Amount

$30

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-09

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
kaleo, Inc.$30
View all Open Payments →|Open Payments Risk Radar →

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 23320)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1902890072.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Pediatrics Physician. Clinical services aligned with this taxonomy classification.
Where in Virginia is Unknown Individual registered?
Use Chesapeake, Virginia as the headline location for Unknown Individual here.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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