Unknown Individual – Critical Care Medicine Nurse Practitioner, NPI 1275535114

Unknown Individual is a healthcare provider. based in Jasper, Alabama. specializing in Critical Care Medicine Nurse Practitioner. They hold a License No. 1 072029 (AL). The NPI Number for Unknown Individual is 1275535114

Main info

Organization
Inactive
32 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1275535114
Phone
(205) 295-1052
Address
12 CHRISTY LN
Deactivation Date
21 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2567362856
Graduation Year
1994 (32 years ago)
PAC ID
8123006707
Group Practice PAC ID
2769450063
Professional Enrollment ID
I20040709001224
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

  • 12 CHRISTY LN

    BLACKWELL MEADOWS

    JASPER, AL 355048496

    Phone: (205) 295-1052

    Type: Mailing

  • 426, School Street, Cordova, Walker County, Alabama, 35550, United States

    CORDOVA, AL 35550

    Phone: (205) 483-7117

    Fax: (205) 483-7177

    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.

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

Insurance plans in this area (ZIP 35504)

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Provider's Procedures

Unknown Individual performs procedures in Critical Care Medicine Nurse Practitioner. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NURSE PRACTITIONERAL81002Urinalysis, manual test6049

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: 2769450063View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1275535114 — is the standard way to identify this listing.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Critical Care Medicine Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Jasper, Alabama as a primary anchor for Unknown Individual unless the record lists multiple sites.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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