Unknown Individual – Family Nurse Practitioner, NPI 1225550932

Unknown Individual is a healthcare provider. based in Longview, Texas. specializing in Family Nurse Practitioner. They hold a License No. AP134397 (TX). The NPI Number for Unknown Individual is 1225550932

Main info

Organization
Inactive
9 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1225550932
Phone
(903) 757-4691
Address
709 HOLLYBROOK DR
Deactivation Date
27 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9037574691
Graduation Year
2017 (9 years ago)
PAC ID
6305103680
Group Practice PAC ID
7214016559
Professional Enrollment ID
I20171121001481

Contacts

Secure Messaging
larry.holman.1@16432.direct.athenahealth.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

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

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Provider Addresses for Unknown Individual

  • 709, Hollybrook Drive, Longview, Gregg County, Texas, 75605, United States

    LONGVIEW, TX 756052411

    Phone: (903) 757-4691

    Type: Location

  • 115, Shawnee Trail, Timber Ridge, Hallsville, Harrison County, Texas, 75650, United States

    HALLSVILLE, TX 756505014

    Phone: (903) 660-0395

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 8 Open Payments records for all available years, with a total value of $229.

Total Amount is formed as General ($229) + Research ($0) + Ownership ($0) = $229.

Last reported payment date: 2024-10-03 • Largest payer in this snapshot: Edwards Lifesciences Corporation ($211).

Total Amount

$229

General + Research + Ownership

Payments

8

Total payment records

General Amount

$229

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-03

Latest reported date

Top Companies

Largest payers in this snapshot

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75605)

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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: 7214016559View full group profile
NameSpecialtyState
-ME
Nurse PractitionerTX
Cardiovascular Disease (Cardiology), Interventional CardiologyTX
-TX
Nurse PractitionerTX
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)ME
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Interventional CardiologyMD

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1225550932.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Longview, Texas?
If you are local to Longview, Texas, Unknown Individual may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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