Unknown Individual – Nurse Practitioner, NPI 1184690976

Unknown Individual is a healthcare provider. based in Indianapolis, Indiana. specializing in Nurse Practitioner. They hold a License No. 71000049 (IN). The NPI Number for Unknown Individual is 1184690976

Main info

Organization
Inactive
33 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1184690976
Phone
(317) 925-0653
Address
3266 N MERIDIAN ST
Deactivation Date
16 December 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3179250653
Graduation Year
1993 (33 years ago)
PAC ID
5092000950
Group Practice PAC ID
6608828181
Professional Enrollment ID
I20160817001750
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

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Provider Addresses for Unknown Individual

  • 3266, North Meridian Street, Meridian Park, Indianapolis, Marion, Indiana, 46208, United States

    STE 101

    INDIANAPOLIS, IN 462085859

    Phone: (317) 925-0653

    Fax: (317) 454-0739

    Type: Mailing

  • 712, North Lincoln Street, Greensburg, Decatur County, Indiana, 47240, United States

    GREENSBURG, IN 472401327

    Phone: (812) 663-8079

    Fax: (812) 663-9298

    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 46208)

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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: 6608828181View full group profile
NameSpecialtyState
-KY
Nurse PractitionerIN
-IN
A N E S T H E S I O L O G YIN
Nurse PractitionerIN
Physician AssistantIN
Physician AssistantIN
Nurse PractitionerMI
Diagnostic RadiologyIN

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1184690976?
NPI 1184690976 belongs to Unknown Individual; compare other details if you need extra assurance.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Indiana is Unknown Individual registered?
Use Indianapolis, Indiana 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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