Unknown Individual – Clinical Social Worker, NPI 1649328840

Unknown Individual is a healthcare provider. based in Nokomis, Florida. specializing in Clinical Social Worker. They hold a License No. SW4767 (FL). The NPI Number for Unknown Individual is 1649328840

Main info

Organization
Inactive
34 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1649328840
Phone
(941) 468-8772
Address
803 SORRENTO PL
Deactivation Date
6 July 2022

Doctor Profile

Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Secondary Phone
2396520260
Graduation Year
1992 (34 years ago)
PAC ID
9830143502
Group Practice PAC ID
3971878398
Professional Enrollment ID
I20050304000701
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

  • 803 SORRENTO PL

    NOKOMIS, FL 342751437

    Phone: (941) 468-8772

    Fax: (941) 378-5808

    Type: Mailing

  • 52 MDG

    UNIT 3865

    APO, AE 09126

    Phone: 496565618285

    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.

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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 34275)

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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: 3971878398View full group profile

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1649328840 when you need to reference Unknown Individual in forms, claims, or directories.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Clinical Social Worker for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Nokomis, Florida for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1649328840. Always confirm identity and privileges with the practice and licensing boards.

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