Unknown Individual – Obstetrics & Gynecology Physician, NPI 1558359604

Unknown Individual is a healthcare provider. based in Huntsville, Alabama. specializing in Obstetrics & Gynecology Physician. They hold a License No. 11282 (AL). The NPI Number for Unknown Individual is 1558359604

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1558359604
Phone
(256) 534-8659
Address
PO BOX 18488
Deactivation Date
13 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2565336311
Graduation Year
1976 (50 years ago)
PAC ID
1456344746
Group Practice PAC ID
2668454802
Professional Enrollment ID
I20170120000776
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

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

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Provider Addresses for Unknown Individual

  • PO BOX 18488

    HUNTSVILLE, AL 358048488

    Phone: (256) 534-8659

    Fax: (256) 533-0276

    Type: Mailing

  • 751, Pleasant Row Northwest, Terry Heights, Huntsville, Madison County, Alabama, 35816, United States

    HUNTSVILLE, AL 358162537

    Phone: (256) 533-6311

    Fax: (256) 536-0801

    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 35804)

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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: 2668454802View full group profile
NameSpecialtyState
Nurse PractitionerAL
Family PracticeTN
Nurse PractitionerAL
-NM
Family PracticeAL
Nurse PractitionerAL
Physician AssistantAL
Family PracticeMD
Family PracticeFL
O B S T E T R I C S/ G Y N E C O L O G YAL

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1558359604 as the unique 10-digit identifier.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Huntsville, Alabama as the reference point for Unknown Individual, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.