Unknown Individual – Nurse Practitioner, NPI 1649337841

Nurse Practitioner

Unknown Individual is a healthcare provider. based in Beaver dam, Kentucky. specializing in Nurse Practitioner. They hold a License No. 71007633A (IN). The NPI Number for Unknown Individual is 1649337841

Main info

Organization

Inactive

22 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1649337841

Phone

(270) 274-9928

Address

1313 N Main St

Deactivation Date

23 October 2025

Doctor Profile

Medical School Name

OTHER

Secondary Phone

2708448515

Graduation Year

2004 (22 years ago)

PAC ID

4284698887

Group Practice PAC ID

3375610116

Professional Enrollment ID

I20041113000287

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience28

Completeness75

Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

1313 N Main St
Beaver Dam, KY 423208957
Phone: (270) 274-9928
Fax: (270) 274-1134
Type: Location
Evansville Post office, 402, Water Street, Evansville, Rock County, Wisconsin, 53536, United States
EVANSVILLE, IN 477061510
Phone: (812) 450-6815
Fax: (812) 450-6822
Type: Mailing
Meijer, 2622, Menards Drive, Smythe, Evansville, Vanderburgh County, Indiana, 47715, United States
EVANSVILLE, IN 477158075
Phone: (812) 450-2622
Fax: (812) 471-2063
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 42320)

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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: 3375610116View full group profile

Name	Specialty	State
GORDON BROWN (M.D.)	Family Practice	IN
DR. NIKOLA CENGELOVA CONRAD (M.D.)	Family Practice	MI
DAVID A CRAIG (MD)	Family Practice	IN
MS. JANET DEANN ZIEGLER (ACNP-BC)	-	IN
TONI M MARTIN (N.P.)	Nurse Practitioner	IN
Unknown Individual	-	TN
NICOLE L STEVENSON (MSN-NPC)	Nurse Practitioner	IN
JON SCOTT ULOTH (M.D.)	-	KY
MRS. KELSEY MARIE KELLY (PA-C)	Physician Assistant	OH
FRANK S HOPKINS (MD)	Internal Medicine, Geriatric Medicine	IN

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?

The NPI 1649337841 uniquely identifies Unknown Individual in U.S. healthcare data.

What should I verify if Unknown Individual is listed inactive?

If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.

What does the directory say Unknown Individual does?

Insurance directories may phrase it differently, but here Unknown Individual maps to Nurse Practitioner. Clinical services aligned with this taxonomy classification.

Can patients visit Unknown Individual in Beaver Dam, Kentucky?

For routing, start with Beaver Dam, Kentucky for Unknown Individual, then verify phone and hours locally.

Can I export Unknown Individual's record?

You can download the official NPPES record; we summarize key fields for readability.