Unknown Individual – Emergency Medicine Physician, NPI 1710935663

Unknown Individual is a healthcare provider. based in Greenville, Alabama. specializing in Emergency Medicine Physician. They hold a License No. 00004219 (AL). The NPI Number for Unknown Individual is 1710935663

Main info

Organization
Inactive
59 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1710935663
Phone
(251) 968-7474
Address
29 L V STABLER DR
Deactivation Date
12 February 2026

Doctor Profile

Medical School Name
LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Secondary Phone
2513002770
Graduation Year
1967 (59 years ago)
PAC ID
6507815545
Group Practice PAC ID
9830330695
Professional Enrollment ID
I20050118000361
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

  • 29 L V STABLER DR

    GREENVILLE, AL 360373850

    Phone: (251) 968-7474

    Type: Location

  • Dukes Liquor Box, 114, Franklin Street, Greenpoint, Brooklyn, Kings County, New York, 11222, United States

    FRANKLIN, TN 370689022

    Phone: (615) 778-8468

    Fax: (615) 778-8468

    Type: Mailing

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 36037)

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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: 9830330695View full group profile
NameSpecialtyState
Family PracticeFL
Internal Medicine, Family PracticeAL
-AL
Nurse PractitionerAL
Internal MedicineAL
Internal MedicineVA

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 1710935663 for Unknown Individual.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Emergency Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Greenville, Alabama?
If you are local to Greenville, Alabama, Unknown Individual may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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