Unknown Individual – Family Nurse Practitioner, NPI 1629470752

Unknown Individual is a healthcare provider. based in Fort smith, Arkansas. specializing in Family Nurse Practitioner. They hold a License No. RN205935 (GA). The NPI Number for Unknown Individual is 1629470752

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1629470752
Phone
(912) 548-0710
Address
1501 S WALDRON RD
Deactivation Date
11 July 2022
Data current as of
20 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

  • 1501 S WALDRON RD

    STE 202

    FORT SMITH, AR 729032598

    Phone: (912) 548-0710

    Fax: (912) 548-0071

    Type: Mailing

  • 615 PENDLETON ST

    SUITE A

    WAYCROSS, GA 315014724

    Phone: (912) 548-0710

    Fax: (912) 548-0071

    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.

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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.

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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 72903)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1629470752.
Does inactive mean outdated data for Unknown Individual?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 Family Nurse Practitioner for Unknown Individual. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Fort Smith, Arkansas. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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