Unknown Individual – Emergency Medicine Physician, NPI 1063416766

Unknown Individual is a healthcare provider. based in Muscle shoals, Alabama. specializing in Emergency Medicine Physician. They hold a License No. 161 (AL). The NPI Number for Unknown Individual is 1063416766

Main info

Organization
Inactive
58 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1063416766
Phone
(256) 383-4473
Address
PO BOX 2587
Deactivation Date
31 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2566612138
Graduation Year
1968 (58 years ago)
PAC ID
4284704065
Group Practice PAC ID
1557406246
Professional Enrollment ID
I20080605000329
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

  • PO BOX 2587

    MUSCLE SHOALS, AL 356622587

    Phone: (256) 383-4473

    Fax: (256) 381-5232

    Type: Mailing

  • 101, Lexington Drive, Chapel Hill, Orange County, North Carolina, 27516, United States

    LEXINGTON, AL 356483249

    Phone: (256) 229-6262

    Fax: (256) 229-6272

    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.

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
36415Insertion of needle into vein for collection of blood sample21975$0
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count21877$0
80053Blood test, comprehensive group of blood chemicals21577$0
82607Cyanocobalamin (vitamin b-12) level19073$0
82746Folic acid level, serum18973$0
View full utilization report →

Insurance plans in this area (ZIP 35662)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1557406246View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1063416766 is assigned to Unknown Individual under the national enumeration system.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Muscle Shoals, Alabama because that is what the record indicates for Unknown Individual.
What if Muscle Shoals, Alabama seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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