Unknown Individual – Nurse Practitioner, NPI 1144562059

Unknown Individual is a healthcare provider. based in Sandy, Utah. specializing in Nurse Practitioner. They hold a License No. 3007974 (KY). The NPI Number for Unknown Individual is 1144562059

Main info

Organization
Inactive
14 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1144562059
Phone
(801) 352-9500
Address
PO BOX 708760
Deactivation Date
18 December 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6066797441
Graduation Year
2012 (14 years ago)
PAC ID
7719128594
Group Practice PAC ID
6204730195
Professional Enrollment ID
I20130719000419
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

Provider Addresses for Unknown Individual

  • PO BOX 708760

    SANDY, UT 840708760

    Phone: (801) 352-9500

    Fax: (801) 352-7976

    Type: Mailing

  • 305 LANGDON ST

    SOMERSET, KY 425032750

    Phone: (606) 679-7441

    Fax: (801) 352-7976

    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 84070)

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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: 6204730195View full group profile

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1144562059?
NPI 1144562059 belongs to Unknown Individual; compare other details if you need extra assurance.
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 Sandy?
Public fields place Unknown Individual around Sandy, Utah. 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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