Unknown Individual – Family Nurse Practitioner, NPI 1679074504

Family Nurse Practitioner

Unknown Individual is a healthcare provider. based in Brownwood, Texas. specializing in Family Nurse Practitioner. They hold a License No. AP136141 (TX). The NPI Number for Unknown Individual is 1679074504

Main info

Organization

Inactive

9 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1679074504

Phone

(254) 893-5895

Address

3804 Hwy 377 South

Deactivation Date

5 December 2022

Doctor Profile

Medical School Name

OTHER

Secondary Phone

2548935895

Graduation Year

2017 (9 years ago)

PAC ID

0941562045

Group Practice PAC ID

6800880824

Professional Enrollment ID

I20180402000065

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience18

Completeness75

Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

3804 Hwy 377 South
Brownwood, TX 768011630
Phone: (254) 893-5895
Type: Location
104 S Park Dr
Brownwood, TX 768015918
Phone: (325) 646-0704
Fax: (866) 247-6022
Type: Location
1100 W REYNOSA AVE
DE LEON, TX 764441630
Phone: (254) 893-5895
Fax: (866) 440-5136
Type: Mailing
135 River North Blvd
Stephenville, TX 764011630
Phone: (254) 893-5895
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 76801)

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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: 6800880824View full group profile

Name	Specialty	State
MEGAN GUIDRY (M.ED, NCC, LPC)	Mental Health Counselor	TX
TOM D. BYRD (M.D.)	-	TX
CHANDRA JANE SIKES (MSN, APRN, PMHNP-BC)	Nurse Practitioner	TX
DR. CHARLES SHANNON CHILDERS (D.O.)	Family Practice	TX
EMMA SHARPE HOGAN (LCSW)	Clinical Social Worker	TX
STARSHA LYNN BROWN (LPC)	Mental Health Counselor	TX
ROY TOM BYRD (MD)	Internal Medicine	TX
TAMMY P. MCCULLOUGH (FNP-C)	Nurse Practitioner	TX
MICHAEL J CLOY (PA)	Physician Assistant	TX
MRS. SHEILA DAWN SPEARS (FNP-C)	Nurse Practitioner	WA

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 1679074504.

Does inactive mean outdated data for Unknown Individual?

Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.

What does the directory say Unknown Individual does?

Insurance directories may phrase it differently, but here Unknown Individual maps to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.

Is Unknown Individual tied to Brownwood, Texas?

If you are local to Brownwood, Texas, Unknown Individual may be relevant to your search.

Why is information missing for Unknown Individual?

Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.