Unknown Individual – Family Nurse Practitioner, NPI 1043490147

Unknown Individual is a healthcare provider. based in Fayetteville, Tennessee. specializing in Family Nurse Practitioner. They hold a License No. APN0000005383 (TN). The NPI Number for Unknown Individual is 1043490147

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1043490147
Phone
(931) 249-7809
Address
552 OLD HUNTSVILLE RD
Deactivation Date
18 December 2020
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

Provider Addresses for Unknown Individual

  • 552 OLD HUNTSVILLE RD

    FAYETTEVILLE, TN 373346029

    Phone: (931) 249-7809

    Fax: (931) 438-2879

    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 37334)

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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 1043490147 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 taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Fayetteville, Tennessee as a primary anchor for Unknown Individual unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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