Unknown Individual – Nurse Practitioner, NPI 1275567695

Unknown Individual is a healthcare provider. based in Bethany, Oklahoma. specializing in Nurse Practitioner. They hold a License No. R0024436 (OK). The NPI Number for Unknown Individual is 1275567695

Main info

Organization
Inactive
30 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1275567695
Phone
(877) 455-4778
Address
6801 NW 39TH EXPRESSWAY
Deactivation Date
23 October 2025

Doctor Profile

Medical School Name
UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Secondary Phone
4057892441
Graduation Year
1996 (30 years ago)
PAC ID
4385707660
Group Practice PAC ID
7517027873
Professional Enrollment ID
I20090113000358
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 6801, Northwest 39th Expressway, Bethany, Oklahoma County, Oklahoma, 73008, United States

    DEACONESS FAMILY CARE, BETHANY

    BETHANY, OK 700088650

    Phone: (877) 455-4778

    Fax: (405) 789-7978

    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 45 Open Payments records for all available years, with a total value of $2,366.

Total Amount is formed as General ($2,366) + Research ($0) + Ownership ($0) = $2,366.

Last reported payment date: 2024-11-13 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($682).

Total Amount

$2,366

General + Research + Ownership

Payments

45

Total payment records

General Amount

$2,366

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-13

Latest reported date

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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
36415Insertion of needle into vein for collection of blood sample19788$0
99213Established patient office or other outpatient visit, 20-29 minutes15475$0
99214Established patient office or other outpatient visit, 30-39 minutes14473$0
87804Detection test by immunoassay with direct visual observation for influenza virus6427$0
96372Injection of drug or substance under skin or into muscle6138$0
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Insurance plans in this area (ZIP 70008)

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Provider's Procedures

Unknown Individual performs procedures in Nurse Practitioner. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NURSE PRACTITIONEROK83036Hemoglobin A1C level3627
NURSE PRACTITIONEROK90670Pneumococcal vaccine for injection into muscle3131

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1275567695 — is the standard way to identify this listing.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Bethany, Oklahoma; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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