Unknown Individual – Family Medicine Physician, NPI 1376570887

Unknown Individual is a healthcare provider. based in Muskogee, Oklahoma. specializing in Family Medicine Physician. They hold a License No. H7620 (TX). The NPI Number for Unknown Individual is 1376570887

Main info

Organization
Inactive
37 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1376570887
Phone
(918) 683-0753
Address
350 S 40TH ST
Deactivation Date
28 December 2022

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Secondary Phone
4794952241
Graduation Year
1989 (37 years ago)
PAC ID
6800972951
Group Practice PAC ID
4688628167
Professional Enrollment ID
I20140306000888

Contacts

Secure Messaging
tim.kay@cmhc.eclinicaldirectplus.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

Loading map...

Provider Addresses for Unknown Individual

  • 350, South 40th Street, Muskogee, Muskogee County, Oklahoma, 74401, United States

    MUSKOGEE, OK 744014915

    Phone: (918) 683-0753

    Fax: (918) 683-5677

    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 74401)

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: 4688628167View full group profile
NameSpecialtyState
-AR
Emergency Medicine, General SurgeryAR
Family Practice, General PracticeAR
General SurgeryAR
Nurse PractitionerAR
Family Practice, General PracticeAR
Certified Clinical Nurse Specialist (Cns)AR
-AR
Nurse PractitionerAR
Nurse PractitionerAR

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

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1376570887; it appears in the national provider directory.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Muskogee, Oklahoma for Unknown Individual based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

Similar Providers

JASON D. DANSBY (MD)

Family Medicine Physician
3330 W OKMULGEE ST
NPI: 1437151578

DR. BRAD A. MCINTOSH (MD)

Family Medicine Physician
3330 W OKMULGEE ST
NPI: 1659373819

DR. JESSE DEWAYNE GEREN (DO)

Family Medicine Physician
4318 W OKMULGEE ST
NPI: 1679578397

JACK EUGENE WEAVER (MD)

Interventional Pain Medicine Physician
4750 S GARNETT RD
NPI: 1902802101
4318 W OKMULGEE ST
NPI: 1538168505

DR. HAROLD L DEMOSS (M.D.)

Family Medicine Physician
Cherokee Nation Three Rivers Health Center, 1001, South 41st Street East, Eastpointe Business Park, Muskogee, Muskogee County, Oklahoma, 74403, United States
NPI: 1245227420

DR. LETICEA MARIE NEWTON (MD)

Family Medicine Physician
PO BOX 751
NPI: 1265422281

ERIC W MIX (DO)

Family Medicine Physician
LOCKBOX #17
NPI: 1003806704
West Gentry Avenue, Checotah, McIntosh County, Oklahoma, 74426, United States
NPI: 1992770796