Unknown Individual – Occupational Therapist, NPI 1063652840

Unknown Individual is a healthcare provider. based in Jacksonville beach, Florida. specializing in Occupational Therapist. They hold a License No. 106577 (TX). The NPI Number for Unknown Individual is 1063652840

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1063652840
Phone
(866) 380-5038
Address
333 1ST ST N STE 200
Deactivation Date
29 April 2023
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1st Street North, Jacksonville Beach, Duval County, Florida, 32250, United States

    C/O PPR HEALTHCARE STAFFING

    JACKSONVILLE BEACH, FL 322506939

    Phone: (866) 380-5038

    Type: Location

  • Medina Valley Health and Rehabilitation, 913, US Highway 90 West, Castroville, Medina County, Texas, 78009, United States

    C/O MEDINA VALLEY HEALTH & REHABILITATION

    CASTROVILLE, TX 780093853

    Phone: (830) 931-2900

    Type: Mailing

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 32250)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1063652840.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What kind of provider is Unknown Individual?
The page reflects Occupational Therapist for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Florida?
You will see Jacksonville Beach, Florida on file for Unknown Individual alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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