Unknown Individual – Neurology Physician, NPI 1790799401

Unknown Individual is a healthcare provider. based in Tuscaloosa, Alabama. specializing in Neurology Physician. They hold a License No. 10073 (AL). The NPI Number for Unknown Individual is 1790799401

Main info

Organization
Inactive
57 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1790799401
Phone
(205) 554-2000
Address
3701 LOOP RD
Deactivation Date
20 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3347121170
Graduation Year
1969 (57 years ago)
PAC ID
6507035136
Group Practice PAC ID
5698714525
Professional Enrollment ID
I20110816000271
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

  • 3701, Loop Road, Mayfair, Box Springs, Tuscaloosa, Tuscaloosa County, Alabama, 35404, United States

    TUSCALOOSA, AL 354045015

    Phone: (205) 554-2000

    Type: Location

  • 657, Trace Crossings Trail, Hoover, Jefferson County, Alabama, 35244, United States

    HOOVER, AL 352443941

    Phone: (205) 554-2000

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $30.

Total Amount is formed as General ($30) + Research ($0) + Ownership ($0) = $30.

Last reported payment date: 2023-08-10 • Largest payer in this snapshot: ABBVIE INC. ($30).

Total Amount

$30

General + Research + Ownership

Payments

2

Total payment records

General Amount

$30

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-08-10

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$30
View all Open Payments →|Open Payments Risk Radar →

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 35404)

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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: 5698714525View full group profile
NameSpecialtyState
N E U R O L O G YAL
P S Y C H I A T R YAL
Family PracticeAL
P S Y C H I A T R YFL
P S Y C H I A T R YAL
-AL
Family PracticeAL
Family PracticeAL
Internal MedicineAL
N E U R O L O G YGA

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1790799401 for Unknown Individual, then check state licensing separately.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Neurology Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Tuscaloosa, Alabama in our summary view.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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