Unknown Individual – Family Nurse Practitioner, NPI 1922086750

Family Nurse Practitioner

Unknown Individual is a healthcare provider. based in Bastian, Virginia. specializing in Family Nurse Practitioner. They hold a License No. 0024034760 (VA). The NPI Number for Unknown Individual is 1922086750

Main info

Organization

Inactive

27 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1922086750

Phone

(276) 688-4331

Address

12301 GRAPEFIELD RD

Deactivation Date

21 February 2024

Doctor Profile

Medical School Name

OTHER

Secondary Phone

2766884331316

Graduation Year

1999 (27 years ago)

PAC ID

8022902212

Group Practice PAC ID

2264326453

Professional Enrollment ID

I20040210000117

Data current as of

19 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

12301 GRAPEFIELD RD
BASTIAN, VA 243144547
Phone: (276) 688-4331
Fax: (276) 688-4336
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)

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 24314)

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Provider's Procedures

Unknown Individual performs procedures in Family Nurse Practitioner. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
NURSE PRACTITIONER	VA	81002	Urinalysis, manual test	31	24

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: 2264326453View full group profile

Name	Specialty	State
SAMANTHA DION RICHARDSON (NP)	Nurse Practitioner	VA
LYNN M. PATTON (FNP)	Nurse Practitioner	VA
MRS. ANGELA NICOLE HUTCHINSON (FNP)	Nurse Practitioner	VA
DEBORAH S CROY (NP)	Nurse Practitioner	VA
ANGELA STROUPE (NP)	Nurse Practitioner	VA
JOHN THOMAS III TURSKI (DO)	Family Practice	VA
MICHAEL O CREWS (DO)	Family Practice	VA
LINDSEY HELDRETH KENNEDY	Nurse Practitioner	VA
PAMELA SUE CROWDER (FNP-BC)	Nurse Practitioner	WV
TIA ELAINE SEXTON	Nurse Practitioner	VA