Unknown Individual – Pediatric Nurse Practitioner, NPI 1548332885

Unknown Individual is a healthcare provider. based in Medford, Oregon. specializing in Pediatric Nurse Practitioner. They hold a License No. 000037718 (OR). The NPI Number for Unknown Individual is 1548332885

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1548332885
Phone
(541) 773-3863
Address
19 MYRTLE ST
Deactivation Date
28 August 2025
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

  • 19, Myrtle Street, Wellington, Medford, Middlesex County, Massachusetts, 02148, United States

    MEDFORD, OR 975047337

    Phone: (541) 773-3863

    Fax: (541) 618-4413

    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 97504)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1548332885 for Unknown Individual, then check state licensing separately.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Pediatric Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Medford, Oregon in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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