Unknown Individual – Family Nurse Practitioner, NPI 1710345038

Unknown Individual is a healthcare provider. based in Greenville, Texas. specializing in Family Nurse Practitioner. They hold a License No. AP130074 (TX). The NPI Number for Unknown Individual is 1710345038

Main info

Organization
Inactive
11 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1710345038
Phone
(903) 583-6155
Address
PO BOX 1908
Deactivation Date
8 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5127303060
Graduation Year
2015 (11 years ago)
PAC ID
0749585149
Group Practice PAC ID
1153602016
Professional Enrollment ID
I20160223001529
Data current as of
20 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

  • 1908, Dunlin Court, Hammonds Pointe, Greenville County, South Carolina, 29687, United States

    GREENVILLE, TX 754031908

    Phone: (903) 583-6155

    Fax: (903) 583-3158

    Type: Mailing

  • 920, North Center Street, Bonham, Fannin County, Texas, 75418, United States

    BONHAM, TX 754183751

    Phone: (906) 583-6155

    Fax: (903) 583-3158

    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 75403)

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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: 1153602016View full group profile
NameSpecialtyState
-TX
Emergency MedicineTX

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1710345038 in the public NPI dataset.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's primary classification?
Family Nurse Practitioner is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Greenville, Texas may find Unknown Individual in results; validate coverage separately.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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