Unknown Individual – Nurse Practitioner, NPI 1396896734

Unknown Individual is a healthcare provider. based in West plains, Missouri. specializing in Nurse Practitioner. They hold a License No. 105248 (MO). The NPI Number for Unknown Individual is 1396896734

Main info

Organization
Inactive
32 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1396896734
Phone
(417) 256-1761
Address
3000 INDEPENDENCE SQ
Deactivation Date
5 March 2026

Doctor Profile

Medical School Name
UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE
Secondary Phone
4172576789
Graduation Year
1994 (32 years ago)
PAC ID
9830243542
Group Practice PAC ID
3870491863
Professional Enrollment ID
I20090814000324
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

  • Independence Square, West Plains, Howell County, Missouri, United States

    WEST PLAINS, MO 657754239

    Phone: (417) 256-1761

    Type: Location

  • 1100, Highway 11, Gowensville, Landrum, Greenville County, South Carolina, 29356, United States

    WEST PLAINS, MO 657751100

    Phone: (417) 257-6782

    Type: Mailing

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 65775)

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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: 3870491863View full group profile
NameSpecialtyState
Nurse PractitionerMO
Nurse PractitionerMO
Family PracticeMO
Physician AssistantOK
-IL
Internal Medicine, RheumatologyMO
A N E S T H E S I O L O G YMO
-MO
-IL
Nurse PractitionerAR

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1396896734.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is West Plains, Missouri in our summary view.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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