Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1093834855

Unknown Individual is a healthcare provider. based in Montgomery, Alabama. specializing in Certified Registered Nurse Anesthetist. They hold a License No. R29012 (ND). The NPI Number for Unknown Individual is 1093834855

Main info

Organization
Inactive
19 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1093834855
Phone
(334) 396-6930
Address
7956 VAUGHN RD
Deactivation Date
27 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2564014467
Graduation Year
2007 (19 years ago)
PAC ID
8224120068
Group Practice PAC ID
5294710398
Professional Enrollment ID
I20070823000839
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

  • 7956 VAUGHN RD

    #165

    MONTGOMERY, AL 361166625

    Phone: (334) 396-6930

    Type: Mailing

  • 315 W HICKORY ST

    SYLACAUGA, AL 351502913

    Phone: (334) 396-6930

    Fax: (334) 279-1660

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $35.

Total Amount is formed as General ($35) + Research ($0) + Ownership ($0) = $35.

Last reported payment date: 2023-11-14 • Largest payer in this snapshot: ABBVIE INC. ($19).

Total Amount

$35

General + Research + Ownership

Payments

2

Total payment records

General Amount

$35

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-14

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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
00813Anesthesia for procedure on small and large bowel using an endoscope4444$0
00142Anesthesia for lens surgery4036$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope2222$0
View full utilization report →

Insurance plans in this area (ZIP 36116)

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Provider's Procedures

Unknown Individual performs procedures in Certified Registered Nurse Anesthetist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CERTIFIED REGISTERED NURSE ANESTHETAL00142Anesthesia for lens surgery3434
CERTIFIED REGISTERED NURSE ANESTHETAL01402Anesthesia for open or endoscopic total knee joint replacement1414

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: 5294710398View full group profile
NameSpecialtyState
Orthopedic SurgeryAL
-AL
Internal MedicineAL
Family PracticeAL
Nurse PractitionerAL
Anesthesiology AssistantAL
H E M A T O L O G Y/ O N C O L O G YAL
A N E S T H E S I O L O G YAL
Emergency MedicineAL
Family PracticeAL

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1093834855 for Unknown Individual.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Certified Registered Nurse Anesthetist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Montgomery, Alabama. Check all listed addresses for suites or satellite offices.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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Unknown Individual

Certified Registered Nurse Anesthetist
Box Turtle, Grogan's Mill, The Woodlands, Montgomery County, Texas, United States
NPI: 1336129337