Unknown Individual – Adult Health Nurse Practitioner, NPI 1164408647

Unknown Individual is a healthcare provider. based in Reno, Nevada. specializing in Adult Health Nurse Practitioner. They hold a License No. APRN001619 (NV). The NPI Number for Unknown Individual is 1164408647

Main info

Organization
Inactive
31 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1164408647
Phone
(775) 982-5966
Address
780 KUENZLI ST STE 202
Deactivation Date
1 November 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7757703327
Graduation Year
1995 (31 years ago)
PAC ID
8921078528
Group Practice PAC ID
7618113523
Professional Enrollment ID
I20150622000548
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

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Provider Addresses for Unknown Individual

  • Kuenzli Street, Reno, Washoe County, Nevada, 89505, United States

    RENO, NV 895020837

    Phone: (775) 982-5966

    Fax: (775) 982-5496

    Type: Mailing

  • 2005, Sierra Highlands Drive, Reno, Washoe County, Nevada, 89523, United States

    STE 101

    RENO, NV 895232303

    Phone: (775) 982-5000

    Fax: (775) 982-6077

    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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit340340$0
G0444Annual depression screening, 5 to 15 minutes268268$0
G0442Annual alcohol misuse screening, 5 to 15 minutes166166$0
G0009Administration of pneumococcal vaccine134134$0
90677Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use125125$0
View full utilization report →

Insurance plans in this area (ZIP 89502)

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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: 7618113523View full group profile
NameSpecialtyState
-NV
Cardiovascular Disease (Cardiology)NV
Cardiovascular Disease (Cardiology)NV
Family PracticeTN
H O S P I T A L I S TNV
-NV
-NV
Family PracticeNV
-NV
Nurse PractitionerPA

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1164408647 — the number used across U.S. healthcare to identify this provider.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Adult Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Reno, Nevada.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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