Unknown Individual – Family Nurse Practitioner, NPI 1114436458

Unknown Individual is a healthcare provider. based in Nicholasville, Kentucky. specializing in Family Nurse Practitioner. They hold a License No. 1126894 (KY). The NPI Number for Unknown Individual is 1114436458

Main info

Organization
Inactive
9 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1114436458
Phone
(859) 260-5540
Address
610 E Brannon Rd Ste 100
Deactivation Date
13 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6063963006
Graduation Year
2017 (9 years ago)
PAC ID
4385906411
Group Practice PAC ID
0143525998
Professional Enrollment ID
I20180329000912
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

  • 610 E Brannon Rd Ste 100

    Nicholasville, KY 403566065

    Phone: (859) 260-5540

    Fax: (859) 260-5545

    Type: Location

  • Park Drive, Chesapeake, Lawrence County, Ohio, 25701, United States

    LAWRENCEBURG, KY 403428074

    Phone: (502) 353-3417

    Type: Location

  • 881, Lauderdale Drive, Lexington, Fayette County, Kentucky, 40515, United States

    LEXINGTON, KY 405156465

    Phone: (859) 402-6968

    Type: Mailing

  • 610 E BRANNON RD STE 100

    NICHOLASVILLE, KY 403566065

    Phone: (859) 260-5540

    Fax: (859) 260-5545

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $98.

Total Amount is formed as General ($98) + Research ($0) + Ownership ($0) = $98.

Last reported payment date: 2023-01-12 • Largest payer in this snapshot: Neurocrine BioSciences, Inc. ($98).

Total Amount

$98

General + Research + Ownership

Payments

1

Total payment records

General Amount

$98

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-12

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes9489$0
87428Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza5050$0
71046X-ray of chest, 2 views3433$0
99212Established patient office or other outpatient visit, 10-19 minutes2726$0
87880Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)2424$0
View full utilization report →

Insurance plans in this area (ZIP 40356)

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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: 0143525998View full group profile

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1114436458 as the unique 10-digit identifier.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Nicholasville?
Public fields place Unknown Individual around Nicholasville, Kentucky. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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