Unknown Individual – Family Medicine Physician, NPI 1619085974

Unknown Individual is a healthcare provider. based in Andalusia, Alabama. specializing in Family Medicine Physician. They hold a License No. 16950 (AL). The NPI Number for Unknown Individual is 1619085974

Main info

Organization
Inactive
35 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1619085974
Phone
(334) 222-2418
Address
135 MEDICAL PARK DR STE 1A
Deactivation Date
16 October 2024

Doctor Profile

Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1991 (35 years ago)
PAC ID
8921167123
Professional Enrollment ID
I20081103000394
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

  • Medical Park Drive, Andalusia, Covington County, Alabama, 36420, United States

    P.O. BOX 1739

    ANDALUSIA, AL 364205323

    Phone: (334) 222-2418

    Fax: (334) 222-0943

    Mailing address matches the actual address.

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
99214Established patient office or other outpatient visit, 30-39 minutes663231$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit193193$0
99213Established patient office or other outpatient visit, 20-29 minutes176113$0
J1100Injection, dexamethasone sodium phosphate, 1 mg16080$0
93005Routine electrocardiogram (ecg) using at least 12 leads with tracing142134$0
View full utilization report →

Insurance plans in this area (ZIP 36420)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEAL93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report301270

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1619085974 as the unique 10-digit identifier.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Andalusia?
Unknown Individual currently maps to Andalusia, Alabama in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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