Unknown Individual – Physical Rehabilitation Occupational Therapist, NPI 1629361365

Unknown Individual is a healthcare provider. based in Draper, Utah. specializing in Physical Rehabilitation Occupational Therapist. They hold a License No. 11862511-6201 (UT). The NPI Number for Unknown Individual is 1629361365

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1629361365
Phone
(505) 850-7168
Address
15017 S EAGLE CREST DR
Deactivation Date
30 August 2023
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 15017 S EAGLE CREST DR

    DRAPER, UT 840205720

    Phone: (505) 850-7168

    Type: Mailing

  • 4701 MONTGOMERY BLVD. NE

    ALBUQUERQUE, NM 871091219

    Phone: (505) 727-4628

    Type: Location

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.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84020)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1629361365 as the unique 10-digit identifier.
Who updates status for Unknown Individual?
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 Physical Rehabilitation Occupational Therapist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Draper?
Unknown Individual currently maps to Draper, Utah in this extract.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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