Unknown Individual – Optometrist, NPI 1316938624

Unknown Individual is a healthcare provider. based in Cheyenne, Wyoming. specializing in Optometrist. They hold a License No. 103T (WY). The NPI Number for Unknown Individual is 1316938624

Main info

Organization
Inactive
54 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1316938624
Phone
(307) 638-2020
Address
2029 BLUEGRASS CIR
Deactivation Date
10 April 2025

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
3076382020
Graduation Year
1972 (54 years ago)
PAC ID
1658470547
Group Practice PAC ID
9335320217
Professional Enrollment ID
I20120820001157
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

  • 2029 BLUEGRASS CIR

    CHEYENNE, WY 820097368

    Phone: (307) 638-2020

    Fax: (307) 634-0939

    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.

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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 82009)

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Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1316938624 uniquely identifies Unknown Individual in U.S. healthcare data.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
How should patients interpret Unknown Individual's specialty?
The extract shows Optometrist for Unknown Individual. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Cheyenne, Wyoming?
If you are local to Cheyenne, Wyoming, Unknown Individual may be relevant to your search.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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