Unknown Individual – Specialist, NPI 1487652632

Specialist

Unknown Individual is a healthcare provider. based in Ogden, Utah. specializing in Specialist. They hold a License No. 100731-4101 (UT). The NPI Number for Unknown Individual is 1487652632

Main info

Organization

Inactive

Name

Unknown Individual

NPI

1487652632

Phone

(801) 399-9955

Address

3955 HARRISON BLVD

Deactivation Date

28 June 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

3955, Harrison Boulevard, Ogden, Weber County, Utah, 84403, United States
SUITE U7
OGDEN, UT 844032313
Phone: (801) 399-9955
Fax: (801) 399-3144
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 84403)

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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 1487652632.

Why is Unknown Individual marked inactive in the NPI directory?

The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Other Service Providers in this dataset. Clinical services aligned with this taxonomy classification.

Where is Unknown Individual based?

Unknown Individual is tied to Ogden, Utah in the data we show; additional addresses may exist on the full record.

What does 'Individual Provider' mean on this profile?

Entity type tells you whether the number belongs to a person or an organization.