Unknown Individual – Family Nurse Practitioner, NPI 1407134091

Unknown Individual is a healthcare provider. based in Naknek, Alaska. specializing in Family Nurse Practitioner. They hold a License No. NP-1079A (ID). The NPI Number for Unknown Individual is 1407134091

Main info

Organization
Inactive
15 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1407134091
Phone
(907) 246-6155
Address
PO BOX 211
Deactivation Date
14 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9072466155
Graduation Year
2011 (15 years ago)
PAC ID
1254502321
Group Practice PAC ID
3476690876
Professional Enrollment ID
I20180503001990
Data current as of
20 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

  • PO BOX 211

    NAKNEK, AK 99633

    Phone: (907) 246-6155

    Fax: (907) 246-6158

    Type: Mailing

  • 2 SCHOOL ROAD

    CAMAI COMMUNITY HEALTH CENTER, INC

    NAKNEK, AK 99633

    Phone: (907) 246-6155

    Type: Location

  • 6509 Highway 2

    Suite 101

    Priest River, ID 838566609

    Phone: (208) 448-2321

    Fax: (208) 448-1317

    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 99633)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3476690876View full group profile
NameSpecialtyState
-AK
Physician AssistantNC
Nurse PractitionerMO
Physician AssistantNH
Nurse PractitionerPA
Nurse PractitionerMO
-AK
Physician AssistantWI
Nurse PractitionerMO
Certified Nurse Midwife (Cnm)AK

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1407134091 is assigned to Unknown Individual under the national enumeration system.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Alaska?
You will see Naknek, Alaska on file for Unknown Individual alongside any extra practice locations.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1407134091. Always confirm identity and privileges with the practice and licensing boards.

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