Unknown Individual – Family Nurse Practitioner, NPI 1467618918

Unknown Individual is a healthcare provider. based in Green cove springs, Florida. specializing in Family Nurse Practitioner. They hold a License No. 11003128 (FL). The NPI Number for Unknown Individual is 1467618918

Main info

Organization
Inactive
18 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1467618918
Phone
(044) 346-9319
Address
411 WALNUT ST # 16469
Deactivation Date
22 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9046421217
Graduation Year
2008 (18 years ago)
PAC ID
9830246529
Group Practice PAC ID
3779573167
Professional Enrollment ID
I20200408003368
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Walnut Street, Hot Springs, Madison County, North Carolina, United States

    GREEN COVE SPRINGS, FL 320433443

    Phone: (044) 346-9319

    Type: Mailing

  • 7720, Merrill Road, Jacksonville, Duval County, Florida, 32277, United States

    JACKSONVILLE, FL 322773715

    Phone: (049) 744-5015

    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 32043)

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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: 3779573167View full group profile

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1467618918 on file in the registry.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Family Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
Where in Florida is Unknown Individual registered?
Use Green Cove Springs, Florida as the headline location for Unknown Individual here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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