Unknown Individual – Family Medicine Physician, NPI 1821007568

Unknown Individual is a healthcare provider. based in Battiest, Oklahoma. specializing in Family Medicine Physician. They hold a License No. 2104 (OK). The NPI Number for Unknown Individual is 1821007568

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1821007568
Phone
(580) 241-5294
Address
PO BOX 180
Deactivation Date
2 August 2021

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
Secondary Phone
5802415294
Graduation Year
1979 (47 years ago)
PAC ID
4587796743
Group Practice PAC ID
7315855541
Professional Enrollment ID
I20100723000215
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

  • PO BOX 180

    BATTIEST, OK 747220180

    Phone: (580) 241-5294

    Fax: (580) 241-5739

    Type: Mailing

  • Kiamichi Family Medical Center, 6026, Battiest-Pickens Road, Battiest, McCurtain County, Oklahoma, 74728, United States

    BROKEN BOW, OK 747285033

    Phone: (580) 241-5294

    Fax: (580) 241-5739

    Type: Location

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 74722)

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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: 7315855541View full group profile
NameSpecialtyState
Physician AssistantOK
Family PracticeOK
-OK
Clinical Social WorkerOK
-OK
Family Practice, Emergency MedicineTN
Physician AssistantOK
Nurse PractitionerOK
General PracticeOK
Family Practice, General PracticeTX

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1821007568.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
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.
Does Unknown Individual practice in Oklahoma?
You will see Battiest, Oklahoma on file for Unknown Individual alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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