Unknown Individual – Preventive Medicine/Occupational Environmental Medicine Physician, NPI 1043253123

Preventive Medicine/Occupational Environmental Medicine Physician

Unknown Individual is a healthcare provider. based in Spring creek, Nevada. specializing in Preventive Medicine/Occupational Environmental Medicine Physician. They hold a License No. 13009 (NV). The NPI Number for Unknown Individual is 1043253123

Main info

Organization

Inactive

37 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1043253123

Phone

(775) 340-2140

Address

177 CHARLWOOD LN

Deactivation Date

30 January 2022

Doctor Profile

Medical School Name

OTHER

Secondary Phone

7023836210

Graduation Year

1989 (37 years ago)

PAC ID

5991865735

Group Practice PAC ID

7315934429

Professional Enrollment ID

I20120327000097

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience24

Completeness75

Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

177, Charlwood Lane, Spring Creek, Elko County, Nevada, 89815, United States
SPRING CREEK, NV 898155350
Phone: (775) 340-2140
Fax: (270) 342-1665
Type: Mailing
South Decatur Boulevard, Buffalo, Las Vegas, Clark County, Nevada, 89107, United States
LAS VEGAS, NV 891035861
Phone: (702) 763-7443
Fax: (270) 342-1665
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 89815)

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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: 7315934429View full group profile

Name	Specialty	State
FREDERICK J LIPPMANN (MD)	-	NV
DONALD C BLAKE (M.D.)	Diagnostic Radiology	TX
NANJUNDA SWAMY SUBRAMANYAM (M.D.)	-	NV
DR. ROGER MEHTA (MD)	-	NV
RAMA HAROUNI (M.D.)	-	NV
DR. SUNIL K PATEL (MD)	General Surgery	NV
MRS. MARIE CAROL REYES (NP)	Nurse Practitioner	NV
DR. FRANK JOEL MCALLISTER (DO)	-	NV
JOSHUA GORDON MARTIN (MD)	Diagnostic Radiology	TX
DR. ZHENG KUN LIU (M.D.)	Internal Medicine	NV

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?

Public records show Unknown Individual under NPI 1043253123.

Does inactive mean outdated data for Unknown Individual?

Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.

What services align with Unknown Individual's listing?

Unknown Individual's public classification highlights Preventive Medicine/Occupational Environmental Medicine Physician. Clinical services aligned with this taxonomy classification.

Which community is linked to Unknown Individual?

Unknown Individual shows a connection to Spring Creek, Nevada in registry-derived data.

Can I export Unknown Individual's record?

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