Unknown Individual – Physician Assistant, NPI 1376522672

Unknown Individual is a healthcare provider. based in Carroll, Iowa. specializing in Physician Assistant. They hold a License No. 000691 (IA). The NPI Number for Unknown Individual is 1376522672

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1376522672
Phone
(712) 792-3581
Address
311 S CLARK ST
Deactivation Date
1 February 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7127923581
Graduation Year
1986 (40 years ago)
PAC ID
4789708876
Group Practice PAC ID
4688586829
Professional Enrollment ID
I20100826000087
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

  • St. Anthony Regional Hospital, 311, South Clark Street, Rolling Hills, Carroll, Carroll County, Iowa, 51401, United States

    CARROLL, IA 514013038

    Phone: (712) 792-3581

    Fax: (712) 792-2124

    Type: Mailing

  • 1st Street, Wall Lake, Sac County, Iowa, 51466, United States

    WALL LAKE, IA 514667014

    Phone: (712) 664-8200

    Fax: (712) 664-2820

    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 51401)

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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: 4688586829View full group profile
NameSpecialtyState
Medical Oncology, HematologyIA
-NE
Certified Registered Nurse Anesthetist (Crna)TN
Nurse PractitionerIA
-IA
Family PracticeUT
Nurse PractitionerIA
Nurse PractitionerIA
N E U R O L O G YSD
Certified Registered Nurse Anesthetist (Crna)NJ

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1376522672 is assigned to Unknown Individual under the national enumeration system.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Physician Assistant for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Carroll, Iowa for Unknown Individual; expand the address list for detail.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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