Unknown Individual – Nurse Practitioner, NPI 1508955543

Unknown Individual is a healthcare provider. based in Wetumpka, Alabama. specializing in Nurse Practitioner. They hold a License No. 1-085631 (AL). The NPI Number for Unknown Individual is 1508955543

Main info

Organization
Inactive
21 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1508955543
Phone
(334) 514-3848
Address
PO BOX 130
Deactivation Date
11 February 2021

Doctor Profile

Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Secondary Phone
3342853222
Graduation Year
2005 (21 years ago)
PAC ID
7618997222
Group Practice PAC ID
3476531039
Professional Enrollment ID
I20051128000833
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • PO BOX 130

    WETUMPKA, AL 360920003

    Phone: (334) 514-3848

    Fax: (334) 514-3686

    Type: Mailing

  • 11 Cambridge Ct

    Wetumpka, AL 360931261

    Phone: (334) 514-3848

    Fax: (334) 514-3686

    Type: Location

  • 14, Deatsville Highway, Springfield, Millbrook, Elmore County, Alabama, 36054, United States

    MILLBROOK, AL 360541994

    Phone: (334) 285-3222

    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 36092)

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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: 3476531039View full group profile
NameSpecialtyState
Family PracticeAL
Nurse PractitionerAL
Internal Medicine, General PracticeFL
Family PracticeAL
Internal MedicineAL

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1508955543; it appears in the national provider directory.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Nurse Practitioner for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Wetumpka, Alabama for Unknown Individual based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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