Unknown Individual – Nurse Practitioner, NPI 1659657369

Unknown Individual is a healthcare provider. based in Salt lake city, Utah. specializing in Nurse Practitioner. They hold a License No. 6578191-4405 (UT). The NPI Number for Unknown Individual is 1659657369

Main info

Organization
Inactive
9 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1659657369
Phone
(801) 944-0095
Address
1545 S 1500 E
Deactivation Date
18 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8012663113
Graduation Year
2017 (9 years ago)
PAC ID
0840459145
Group Practice PAC ID
8426362450
Professional Enrollment ID
I20120306000589
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 1545 S 1500 E

    SALT LAKE CITY, UT 841052817

    Phone: (801) 944-0095

    Type: Mailing

  • 5292 S COLLEGE DR

    MURRAY, UT 841232958

    Phone: (801) 944-0095

    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 84105)

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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: 8426362450View full group profile
NameSpecialtyState
Nurse PractitionerCO
Nurse PractitionerUT
Nurse PractitionerNM
Family PracticeNM
Nurse PractitionerUT
P O D I A T R YNM
Family Practice, Pediatric MedicineUT
Nurse PractitionerNM
Nurse PractitionerUT
Nurse PractitionerNM

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1659657369 is assigned to Unknown Individual under the national enumeration system.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Salt Lake City, Utah for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1659657369. Always confirm identity and privileges with the practice and licensing boards.

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