Unknown Individual – Emergency Medical Services (Emergency Medicine) Physician, NPI 1790717882

Unknown Individual is a healthcare provider. based in Fruita, Colorado. specializing in Emergency Medical Services (Emergency Medicine) Physician. They hold a License No. DR.0031923 (CO). The NPI Number for Unknown Individual is 1790717882

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1790717882
Phone
(970) 858-2119
Address
PO BOX 130
Deactivation Date
25 March 2022

Contacts

Secure Messaging
josephkupets@fhwco.cernerdirect.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • PO BOX 130

    FRUITA, CO 815210130

    Phone: (970) 858-2119

    Fax: (970) 858-2743

    Type: Mailing

  • Colorado Canyons Hospital and Medical Center, 300, West Ottley Avenue, Fruita, Mesa County, Colorado, 81521, United States

    FRUITA, CO 815212118

    Phone: (970) 858-2119

    Fax: (970) 858-2743

    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.

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 81521)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1790717882.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Emergency Medical Services (Emergency Medicine) Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Fruita, Colorado as a primary anchor for Unknown Individual unless the record lists multiple sites.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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