Unknown Individual – Optometrist, NPI 1114086261

Unknown Individual is a healthcare provider. based in Blackfoot, Idaho. specializing in Optometrist. They hold a License No. 0689 (ID). The NPI Number for Unknown Individual is 1114086261

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1114086261
Phone
(208) 785-7274
Address
PO BOX 1052
Deactivation Date
19 April 2023
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

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Provider Addresses for Unknown Individual

  • PO BOX 1052

    BLACKFOOT, ID 832211052

    Phone: (208) 785-7274

    Fax: (208) 785-7337

    Type: Mailing

  • 34, Southeast Main Street, Blackfoot, Bingham County, Idaho, 83221, United States

    BLACKFOOT, ID 832212959

    Phone: (208) 785-7274

    Fax: (208) 785-7337

    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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83221)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1114086261 if you need a stable reference for Unknown Individual.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Optometrist. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Blackfoot, Idaho for Unknown Individual based on available NPPES addresses.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1114086261. Always confirm identity and privileges with the practice and licensing boards.

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