Unknown Individual – Nurse Practitioner, NPI 1861880239

Unknown Individual is a healthcare provider. based in Dallas, Texas. specializing in Nurse Practitioner. They hold a License No. AP126591 (TX). The NPI Number for Unknown Individual is 1861880239

Main info

Organization
Inactive
12 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1861880239
Phone
(214) 645-0595
Address
PO BOX 845347
Deactivation Date
15 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2014 (12 years ago)
PAC ID
8820312630
Group Practice PAC ID
1355254210
Professional Enrollment ID
I20150128000276
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • PO BOX 845347

    DALLAS, TX 752845347

    Phone: (214) 645-0595

    Fax: (214) 645-0078

    Type: Mailing

  • 5323 HARRY HINES BLVD

    DALLAS, TX 753907201

    Phone: (214) 645-0595

    Fax: (214) 645-0078

    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 75284)

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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: 1355254210View full group profile
NameSpecialtyState
Radiation OncologyTX
Nurse PractitionerTX
Internal MedicineTX
-TX
-TX
Clinical Social WorkerTX
-TX
Nurse PractitionerTX
Orthopedic SurgeryTX
Clinical PsychologistTX

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1861880239 as the unique 10-digit identifier.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Dallas?
Public fields place Unknown Individual around Dallas, Texas. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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