Unknown Individual – Acute Care Nurse Practitioner, NPI 1609847672

Unknown Individual is a healthcare provider. based in Fort worth, Texas. specializing in Acute Care Nurse Practitioner. They hold a License No. 698068 (TX). The NPI Number for Unknown Individual is 1609847672

Main info

Organization
Inactive
26 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1609847672
Phone
(817) 413-0943
Address
4732 E LANCASTER AVE STE B
Deactivation Date
5 January 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8175891734
Graduation Year
2000 (26 years ago)
PAC ID
7012983257
Group Practice PAC ID
1557319183
Professional Enrollment ID
I20040908001324
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

  • 4732 E LANCASTER AVE STE B

    FORT WORTH, TX 761033836

    Phone: (817) 413-0943

    Fax: (817) 413-6481

    Mailing address matches the actual address.

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 76103)

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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: 1557319183View full group profile
NameSpecialtyState
-TX

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1609847672 for Unknown Individual.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
How should patients interpret Unknown Individual's specialty?
The extract shows Acute Care Nurse Practitioner for Unknown Individual. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Fort Worth, Texas. Check all listed addresses for suites or satellite offices.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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