Unknown Individual – Family Nurse Practitioner, NPI 1366561540

Unknown Individual is a healthcare provider. based in Essex junction, Vermont. specializing in Family Nurse Practitioner. They hold a License No. 1010010188 (VT). The NPI Number for Unknown Individual is 1366561540

Main info

Organization
Inactive
28 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1366561540
Phone
(802) 847-6067
Address
31 FOSTER RD
Deactivation Date
26 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8028470000
Graduation Year
1998 (28 years ago)
PAC ID
5395766232
Group Practice PAC ID
3779491071
Professional Enrollment ID
I20051207000785
Data current as of
19 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

  • 31 FOSTER RD

    ESSEX JUNCTION, VT 054523315

    Phone: (802) 847-6067

    Fax: (802) 847-1422

    Type: Mailing

  • 62 TILLEY DR

    SOUTH BURLINGTON, VT 054034407

    Phone: (802) 847-6067

    Fax: (802) 847-1422

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes462351$0
View full utilization report →

Insurance plans in this area (ZIP 05452)

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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: 3779491071View full group profile

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1366561540.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Essex Junction, Vermont as a primary anchor for Unknown Individual unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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