Unknown Individual – Nurse Practitioner, NPI 1790822518

Unknown Individual is a healthcare provider. based in Carson city, Nevada. specializing in Nurse Practitioner. They hold a License No. APN001257 (NV). The NPI Number for Unknown Individual is 1790822518

Main info

Organization
Inactive
19 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1790822518
Phone
(775) 883-1030
Address
1425 VISTA LN
Deactivation Date
2 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7758850198
Graduation Year
2007 (19 years ago)
PAC ID
4385829621
Group Practice PAC ID
1759277957
Professional Enrollment ID
I20110513000019
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

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Provider Addresses for Unknown Individual

  • Vista Lane, Carson City, Nevada, 89703, United States

    CARSON CITY, NV 897034644

    Phone: (775) 883-1030

    Fax: (775) 884-6233

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 13 Open Payments records for all available years, with a total value of $1,393.

Total Amount is formed as General ($1,393) + Research ($0) + Ownership ($0) = $1,393.

Last reported payment date: 2024-10-09 • Largest payer in this snapshot: Abbott Laboratories ($1,329).

Total Amount

$1,393

General + Research + Ownership

Payments

13

Total payment records

General Amount

$1,393

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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 89703)

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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: 1759277957View full group profile
NameSpecialtyState
-NV

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1790822518 when you need to reference Unknown Individual in forms, claims, or directories.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Nurse Practitioner for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Carson City, Nevada because that is what the record indicates for Unknown Individual.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1790822518. Always confirm identity and privileges with the practice and licensing boards.

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