Unknown Individual – Nurse Practitioner, NPI 1710907373

Unknown Individual is a healthcare provider. based in Reno, Nevada. specializing in Nurse Practitioner. They hold a License No. RN16484 (NV). The NPI Number for Unknown Individual is 1710907373

Main info

Organization
Inactive
21 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1710907373
Phone
(775) 622-2874
Address
164 HUBBARD WAY STE A
Deactivation Date
16 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7754401520
Graduation Year
2005 (21 years ago)
PAC ID
9638177066
Group Practice PAC ID
8022352400
Professional Enrollment ID
I20061120000370
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 164 HUBBARD WAY STE A

    RENO, NV 895023781

    Phone: (775) 622-2874

    Type: Location

  • Sparks Post Office, 102, South Goodman Street, Sparks, Cook County, Georgia, 31647, United States

    SPARKS, NV 894323661

    Phone: (775) 622-6115

    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 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: 8022352400View full group profile
NameSpecialtyState
-NV

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1710907373 on file in the registry.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Reno, Nevada.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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