Unknown Individual – Family Nurse Practitioner, NPI 1629130547

Family Nurse Practitioner

Unknown Individual is a healthcare provider. based in Abilene, Texas. specializing in Family Nurse Practitioner. They hold a License No. 547116 (TX). The NPI Number for Unknown Individual is 1629130547

Main info

Organization

Inactive

28 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1629130547

Phone

(325) 690-1500

Address

4009 RIDGEMONT DR

Deactivation Date

8 April 2021

Doctor Profile

Medical School Name

OTHER

Secondary Phone

3257953515

Graduation Year

1998 (28 years ago)

PAC ID

0840424081

Group Practice PAC ID

2163795824

Professional Enrollment ID

I20131002000038

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

4009, Ridgemont Drive, Abilene, Taylor County, Texas, 79606, United States
ABILENE, TX 796062733
Phone: (325) 690-1500
Fax: (325) 690-1578
Type: Location
1732, Alamo Court, Clyde, Callahan County, Texas, 79510, United States
CLYDE, TX 795103501
Phone: (325) 893-5498
Type: Mailing

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 79606)

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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: 2163795824View full group profile

Name	Specialty	State
DR. STANLEY CAL (MD)	-	TX
VICKY L LITTON (MD)	-	TX
DR. SHAWN D PIERCE (MD)	Family Practice	TX
OLENA SHVETS (PMHNP)	-	TX
JOHN K HARPER (MD)	-	TX
DR. ROBERT G AGUILAR (D.P.M.)	P O D I A T R Y	TX
KRISTA DAWN HAMILTON (FNP-C)	Nurse Practitioner	TX
VAMSEEDHAR ALLA (M.D.)	Internal Medicine	CT
DR. STEPHEN G JR. POPLAR (M.D.)	P S Y C H I A T R Y	LA
MEGAN ELIZABETH DEEL (PMHNP-BC)	-	TX

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?

CMS-hosted NPPES data lists Unknown Individual with NPI 1629130547.

Is Unknown Individual excluded from programs when inactive?

The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.

Where should I expect Unknown Individual on a map?

Expect Abilene, Texas as a primary anchor for Unknown Individual unless the record lists multiple sites.

How many locations tie to this NPI?

2 practice locations appear in the available data.