Unknown Individual – Family Medicine Physician, NPI 1356400139

Family Medicine Physician

Unknown Individual is a healthcare provider. based in Stilwell, Oklahoma. specializing in Family Medicine Physician. They hold a License No. 2558 (OK). The NPI Number for Unknown Individual is 1356400139

Main info

Organization

Inactive

41 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1356400139

Phone

(918) 696-8812

Address

RR 6 BOX 840

Deactivation Date

1 November 2023

Doctor Profile

Medical School Name

OTHER

Secondary Phone

9184583100

Graduation Year

1985 (41 years ago)

PAC ID

5698736445

Group Practice PAC ID

5799698742

Professional Enrollment ID

I20050726000498

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

Provider Addresses for Unknown Individual

RR 6 BOX 840
STILWELL, OK 749608703
Phone: (918) 696-8812
Fax: (918) 696-3879
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 74960)

Loading plans...

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: 5799698742View full group profile

Name	Specialty	State
DR. LEILA DANIELLE SEE (D.O.)	Diagnostic Radiology	OK
DR. BARINDER PAUL BASSI (DPM)	P O D I A T R Y	OK
ANN NGUYEN (D.P.M)	-	OK
KENDRA DIANE ROUND (CNP)	-	OK
JOHNSON C JR. GOURD (M.D.)	-	OK
DR. SARAH COURTNEY KNIFE CHIEF (M.D.)	-	OK
CATHY JUDEAN FIELDER (PA-C)	-	OK
MYO WIN (M.D)	Internal Medicine	MO
GREGORY S. BROOKS (DO)	-	OK
DR. LAURA LAI MING CHAN (OD)	-	OK

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I verify Unknown Individual with an NPI only?

You can start verification with NPI 1356400139 for Unknown Individual, then check state licensing separately.

Is Unknown Individual excluded from programs when inactive?

The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.

What area does Unknown Individual serve?

Unknown Individual's listing highlights Stilwell, Oklahoma; more addresses can appear in NPPES.

Is specialty guaranteed by NPI alone?

Taxonomy selections describe intent; scope of practice still follows state law.