Unknown Individual – Emergency Medicine Physician, NPI 1710962535
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
101 CRESTVIEW AVE
EVERGREEN, AL 364013333
Phone: (251) 578-2480
Fax: (251) 578-1055
Type: Location
101, Montesano Drive, Evergreen, Conecuh County, Alabama, 36401, United States
EVERGREEN, AL 364012610
Phone: (251) 578-1382
Type: Mailing
847 W Bypass Ste A
Andalusia, AL 364204747
Phone: (334) 222-1366
Fax: (334) 222-1150
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $92.
Total Amount is formed as General ($92) + Research ($0) + Ownership ($0) = $92.
Last reported payment date: 2024-11-05 • Largest payer in this snapshot: Abbott Laboratories ($21).
Total Amount
$92
General + Research + Ownership
Payments
5
Total payment records
General Amount
$92
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $21 |
| Medtronic, Inc. | $19 |
| ABBVIE INC. | $19 |
| Novo Nordisk Inc | $19 |
| Ferring Pharmaceuticals Inc. | $14 |
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 13 | 13 | $0 |
Insurance plans in this area (ZIP 36401)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | AL | |
| Nurse Practitioner | AL | |
| Nurse Practitioner | AL | |
| Nurse Practitioner | AL |
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