Unknown Individual – Family Nurse Practitioner, NPI 1639444011

Unknown Individual is a healthcare provider. based in Virginia beach, Virginia. specializing in Family Nurse Practitioner. They hold a License No. 0001187568 (VA). The NPI Number for Unknown Individual is 1639444011

Main info

Organization
Inactive
15 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1639444011
Phone
(757) 481-4383
Address
1704 SIR WILLIAM OSLER DR
Deactivation Date
4 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7574814383
Graduation Year
2011 (15 years ago)
PAC ID
7214255603
Group Practice PAC ID
5496760522
Professional Enrollment ID
I20160114002013
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

  • 1704 SIR WILLIAM OSLER DR

    VIRGINIA BEACH, VA 234543003

    Phone: (757) 481-4383

    Fax: (757) 481-4611

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 204 Open Payments records for all available years, with a total value of $5,178.

Total Amount is formed as General ($5,178) + Research ($0) + Ownership ($0) = $5,178.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($881).

Total Amount

$5,178

General + Research + Ownership

Payments

204

Total payment records

General Amount

$5,178

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

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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 23454)

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Provider's Procedures

Unknown Individual performs procedures in Family Nurse Practitioner. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NURSE PRACTITIONERVA95117Injection of incremental dosages of allergen, 2 or more injections1616

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: 5496760522View full group profile
NameSpecialtyState
A L L E R G Y/ I M M U N O L O G YVA
Physician AssistantVA
A L L E R G Y/ I M M U N O L O G YVA
A L L E R G Y/ I M M U N O L O G YVA
-VA
A L L E R G Y/ I M M U N O L O G YVA

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1639444011 as the unique 10-digit identifier.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Family Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Virginia Beach, Virginia.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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