Unknown Individual – Nurse Practitioner, NPI 1093091381

Nurse Practitioner

Unknown Individual is a healthcare provider. based in Sheridan, Wyoming. specializing in Nurse Practitioner. They hold a License No. 17680.1131 (WY). The NPI Number for Unknown Individual is 1093091381

Main info

Organization

Inactive

15 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1093091381

Phone

(307) 675-3112

Address

1898 FORT RD

Deactivation Date

26 February 2026

Doctor Profile

Medical School Name

OTHER

Secondary Phone

3076721000

Graduation Year

2011 (15 years ago)

PAC ID

5890838403

Group Practice PAC ID

1254476484

Professional Enrollment ID

I20160908002525

Contacts

Secure Messaging

mkawulok@sheridan.cernerdirect.com

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience19

Completeness85

Years active:0State licenses:1Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

1898 FORT RD
SHERIDAN, WY 828018320
Phone: (307) 675-3112
Type: Mailing
1435 Burton St
Sheridan, WY 828012723
Phone: (307) 675-5850
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

HCPCS	Description	Services	Beneficiaries	Medicare allowed
99213	Established patient office or other outpatient visit, 20-29 minutes	494	431	$0
J1885	Injection, ketorolac tromethamine, per 15 mg	131	37	$0
81003	Automated urinalysis test	101	94	$0
99203	New patient office or other outpatient visit, 30-44 minutes	100	100	$0
96372	Injection of drug or substance under skin or into muscle	54	46	$0

View full utilization report →

Insurance plans in this area (ZIP 82801)

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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: 1254476484View full group profile

Name	Specialty	State
DR. JOSHUA A SCOTT (MD)	General Surgery	WY
DR. BARRY E MANGUS (MD)	General Surgery	WY
ERIN MARIE HENDERSON (M.D.)	Internal Medicine	CO
ABIGAIL TURNBOUGH	Internal Medicine	CO
ANTHONY B QUINN (M.D.)	Orthopedic Surgery	WY
REBECCA A KRZYMINSKI (D.O.)	O B S T E T R I C S/ G Y N E C O L O G Y	TN
LACI LITTLE (N.P.)	Nurse Practitioner	WY
DR. ALLISON DAWSON (MD)	Internal Medicine	IL
MICHAEL PHILLIP KINNEY	P S Y C H I A T R Y	WA
WENDY PRICE (PA-C)	-	WY