Unknown Individual – Family Nurse Practitioner, NPI 1295743771

Unknown Individual is a healthcare provider. based in Santa fe, New Mexico. specializing in Family Nurse Practitioner. They hold a License No. CNP00609 (NM). The NPI Number for Unknown Individual is 1295743771

Main info

Organization
Inactive
21 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1295743771
Phone
(505) 471-4660
Address
2907 CERRILLOS RD
Deactivation Date
31 May 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8663892727
Graduation Year
2005 (21 years ago)
PAC ID
0042239907
Group Practice PAC ID
7517280266
Professional Enrollment ID
I20051215000473
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

  • CVS Pharmacy, 2907, Cerrillos Road, Santa Fe, Santa Fe County, New Mexico, 87507, United States

    MINUTE CLINIC

    SANTA FE, NM 87501

    Phone: (505) 471-4660

    Type: Location

  • 1457, Wilkes Way Southeast, Rio Rancho, Sandoval County, New Mexico, 87124, United States

    RIO RANCHO, NM 871240992

    Phone: (575) 302-8278

    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 87501)

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Provider's Procedures

Unknown Individual performs procedures in Family Nurse Practitioner. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NURSE PRACTITIONERNM90670Pneumococcal vaccine for injection into muscle4747

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: 7517280266View full group profile
NameSpecialtyState
Nurse PractitionerMO
Nurse PractitionerWA
Nurse PractitionerMO
-NM
-NM
Nurse PractitionerNM
Physician AssistantMN

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1295743771 as the unique 10-digit identifier.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Family Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
Where in New Mexico is Unknown Individual registered?
Use Santa Fe, New Mexico as the headline location for Unknown Individual here.
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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