Unknown Individual – Endocrinology, Diabetes & Metabolism Physician, NPI 1720040025

Endocrinology, Diabetes & Metabolism Physician

Unknown Individual is a healthcare provider. based in Birmingham, Alabama. specializing in Endocrinology, Diabetes & Metabolism Physician. They hold a License No. 16875 (AL). The NPI Number for Unknown Individual is 1720040025

Main info

Organization

Inactive

40 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1720040025

Phone

(205) 802-6722

Address

513 BROOKWOOD BLVD

Deactivation Date

28 January 2022

Doctor Profile

Medical School Name

MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE

Secondary Phone

2057155943

Graduation Year

1986 (40 years ago)

PAC ID

8224126214

Group Practice PAC ID

3476457011

Professional Enrollment ID

I20110412000010

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

NW Corner of Brookwood Blvd & Brookwood Medical Center Dr, 2010, Brookwood Medical Center Drive, Southwood, Birmingham, Jefferson County, Alabama, 35209, United States
SUITE 400
BIRMINGHAM, AL 352096862
Phone: (205) 802-6722
Fax: (205) 802-6730
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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35209)

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Provider's Procedures

Unknown Individual performs procedures in Endocrinology, Diabetes & Metabolism Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
ENDOCRINOLOGY	AL	83036	Hemoglobin A1C level	664	288

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: 3476457011View full group profile

Name	Specialty	State
DR. DANIEL JASON MORRIS (D.O.)	Orthopedic Surgery	AL
DR. DALE SCOTT JR. KIRBY (MD)	Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)	AL
HEATHER RENE WALDRUP (M.D.)	General Surgery	AL
ADRIENNE NICOLE SHAMBRAY (CRNP)	Nurse Practitioner	AL
BEN E PARRISH (M.D.)	-	AL
MRS. FRANCES SHEFFIELD (FNP-C)	-	AL
CALEB JORDAN GRAY (MSN, FNP-C)	Nurse Practitioner	AL
JAMES TERRY WHITE (MD)	Cardiovascular Disease (Cardiology)	AL
STANLEY W. JETT (M.D.)	-	AL
JENNIFER MCINNISH (AUD)	Qualified Audiologist	AL

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?

The NPI 1720040025 uniquely identifies Unknown Individual in U.S. healthcare data.

What does inactive NPI status mean for Unknown Individual?

Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.

Which specialty label fits Unknown Individual?

NPPES ties Unknown Individual to Endocrinology, Diabetes & Metabolism Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.

Which community is linked to Unknown Individual?

Unknown Individual shows a connection to Birmingham, Alabama in registry-derived data.

Who maintains Unknown Individual's record?

Providers certify NPPES data; CMS hosts the public file you are viewing.