Unknown Individual – Critical Care Medicine Nurse Practitioner, NPI 1770505901

Unknown Individual is a healthcare provider. based in Midland, Texas. specializing in Critical Care Medicine Nurse Practitioner. They hold a License No. 251442 (TX). The NPI Number for Unknown Individual is 1770505901

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1770505901
Phone
(432) 580-3700
Address
3409 ANDREWS HWY
Deactivation Date
9 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4325822882
Graduation Year
1985 (41 years ago)
PAC ID
0840398897
Group Practice PAC ID
7618152281
Professional Enrollment ID
I20070614000373
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

  • Gonzales Health & Rehab, 3409, Andrews Highway, Radio Plaza, Midland, Midland County, Texas, 79703, United States

    MIDLAND, TX 797035149

    Phone: (432) 580-3700

    Fax: (432) 580-3707

    Type: Location

  • Grant Avenue Heights, Westside, Odessa, Ector County, Texas, 79767, United States

    ODESSA, TX 797613208

    Phone: (432) 580-3700

    Fax: (432) 580-3707

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $16.

Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.

Last reported payment date: 2023-08-16 • Largest payer in this snapshot: Abbott Laboratories ($16).

Total Amount

$16

General + Research + Ownership

Payments

1

Total payment records

General Amount

$16

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-08-16

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Abbott Laboratories$16
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 79703)

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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: 7618152281View full group profile
NameSpecialtyState
Physician AssistantTX
Family PracticeTX
Physician AssistantTX
Physician AssistantTX
Physician AssistantTX
Nurse PractitionerTX
Physician AssistantTX
Physician AssistantTX
Physician AssistantCT

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1770505901 when you need to reference Unknown Individual in forms, claims, or directories.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Critical Care Medicine Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Midland, Texas for Unknown Individual based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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