Unknown Individual – Occupational Medicine Physician, NPI 1619050309

Unknown Individual is a healthcare provider. based in Oklahoma city, Oklahoma. specializing in Occupational Medicine Physician. They hold a License No. 1646 (OK). The NPI Number for Unknown Individual is 1619050309

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1619050309
Phone
(405) 239-7766
Address
1211 N SHARTEL
Deactivation Date
6 July 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

  • 1211, North Shartel Avenue, Midtown Oklahoma City, Oklahoma City, Oklahoma County, Oklahoma, 73103, United States

    SUITE 500

    OKLAHOMA CITY, OK 731032433

    Phone: (405) 239-7766

    Fax: (405) 235-4895

    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 73103)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1619050309 on file in the registry.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Occupational Medicine Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Oklahoma City, Oklahoma.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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