Unknown Individual – Rheumatology Physician, NPI 1891767638

Unknown Individual is a healthcare provider. based in Henderson, Nevada. specializing in Rheumatology Physician. They hold a License No. 1244 (NV). The NPI Number for Unknown Individual is 1891767638

Main info

Organization
Inactive
53 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1891767638
Phone
(702) 777-1777
Address
874 AMERICAN PACIFIC DR
Deactivation Date
12 February 2026

Doctor Profile

Medical School Name
KANSAS CITY MEDICAL COLLEGE
Secondary Phone
7026716412
Graduation Year
1973 (53 years ago)
PAC ID
3577539832
Group Practice PAC ID
4183991458
Professional Enrollment ID
I20060227000291
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

  • 874, American Pacific Drive, Henderson, Clark County, Nevada, 89014, United States

    HENDERSON, NV 890148800

    Phone: (702) 777-1777

    Fax: (702) 777-1789

    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 3 Open Payments records for all available years, with a total value of $375.

Total Amount is formed as General ($375) + Research ($0) + Ownership ($0) = $375.

Last reported payment date: 2023-06-12 • Largest payer in this snapshot: ABBVIE INC. ($375).

Total Amount

$375

General + Research + Ownership

Payments

3

Total payment records

General Amount

$375

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-06-12

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$375
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 89014)

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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: 4183991458View full group profile

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1891767638.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Rheumatology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Henderson, Nevada?
For routing, start with Henderson, Nevada for Unknown Individual, then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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