Unknown Individual – Pediatric Nurse Practitioner, NPI 1679565592

Unknown Individual is a healthcare provider. based in Des moines, Iowa. specializing in Pediatric Nurse Practitioner. They hold a License No. C079344 (IA). The NPI Number for Unknown Individual is 1679565592

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1679565592
Phone
(515) 241-8336
Address
1215 PLEASANT ST.
Deactivation Date
1 March 2022
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

  • Methodist Medical Plaza II, 1215, Pleasant Street, Sherman Hill, Des Moines, Polk County, Iowa, 50309, United States

    SUITE 406

    DES MOINES, IA 503091453

    Phone: (515) 241-8336

    Fax: (515) 241-6465

    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.

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 50309)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1679565592.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Pediatric Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Des Moines, Iowa 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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