Unknown Individual – Obstetrics & Gynecology Physician, NPI 1487761466

Unknown Individual is a healthcare provider. based in Scottsbluff, Nebraska. specializing in Obstetrics & Gynecology Physician. They hold a License No. 23352 (NE). The NPI Number for Unknown Individual is 1487761466

Main info

Organization
Inactive
22 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1487761466
Phone
(308) 635-3033
Address
3911 AVENUE B
Deactivation Date
31 January 2022

Doctor Profile

Medical School Name
UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Secondary Phone
3084325586
Graduation Year
2004 (22 years ago)
PAC ID
7214943778
Group Practice PAC ID
2062301609
Professional Enrollment ID
I20060221000917
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

  • 3911, Avenue B, Scottsbluff, Scotts Bluff County, Nebraska, 69361, United States

    SUITE 3100

    SCOTTSBLUFF, NE 693614617

    Phone: (308) 635-3033

    Type: Location

  • Highland Road, Scottsbluff, Scotts Bluff County, Nebraska, 69363, United States

    SCOTTSBLUFF, NE 693617721

    Phone: (308) 635-3033

    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 69361)

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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: 2062301609View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YNE
Physical Medicine And Rehabilitation, Pain ManagementNE
Family PracticeNE
-NE
Physician AssistantAZ
P S Y C H I A T R YTX
-NE
Family PracticeNE
N E U R O S U R G E R YSD
H E M A T O L O G Y/ O N C O L O G YCO

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1487761466 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 field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Scottsbluff, Nebraska for Unknown Individual; download NPPES for the complete set.
What if Scottsbluff, Nebraska seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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