Unknown Individual – Family Medicine Physician, NPI 1851366942

Unknown Individual is a healthcare provider. based in Holdenville, Oklahoma. specializing in Family Medicine Physician. They hold a License No. 13854 (OK). The NPI Number for Unknown Individual is 1851366942

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1851366942
Phone
(405) 379-4200
Address
100 MCDOUGAL DR
Deactivation Date
21 April 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1981 (45 years ago)
PAC ID
4284613985
Group Practice PAC ID
6002031424
Professional Enrollment ID
I20040721001127
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

  • Holdenville General Hospital, 100, McDougal Drive, Holdenville, Hughes County, Oklahoma, 74848, United States

    HOLDENVILLE, OK 748482822

    Phone: (405) 379-4200

    Fax: (405) 379-4284

    Type: Mailing

  • West 1st Street, Wewoka, Seminole County, Oklahoma, 74884, United States

    WEWOKA, OK 748845097

    Phone: (405) 257-3396

    Fax: (405) 257-6908

    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 74848)

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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: 6002031424View full group profile

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1851366942 — the number used across U.S. healthcare to identify this provider.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Holdenville?
Unknown Individual currently maps to Holdenville, Oklahoma in this extract.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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