Unknown Individual – Endocrinology, Diabetes & Metabolism Physician, NPI 1851375679

Unknown Individual is a healthcare provider. based in Dothan, Alabama. specializing in Endocrinology, Diabetes & Metabolism Physician. They hold a License No. 30488 (AL). The NPI Number for Unknown Individual is 1851375679

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1851375679
Phone
(334) 794-1148
Address
1118 ROSS CLARK CIR
Deactivation Date
14 June 2023

Doctor Profile

Medical School Name
SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3347941148
Graduation Year
1986 (40 years ago)
PAC ID
5698679769
Group Practice PAC ID
7416848247
Professional Enrollment ID
I20110119001216
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

  • 1118, Ross Clark Circle, Morris Heights, Dothan, Houston County, Alabama, 36301, United States

    SUITE 100

    DOTHAN, AL 363013027

    Phone: (334) 794-1148

    Fax: (334) 793-1954

    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)

CMS reports 13 Open Payments records for all available years, with a total value of $215.

Total Amount is formed as General ($215) + Research ($0) + Ownership ($0) = $215.

Last reported payment date: 2024-04-25 • Largest payer in this snapshot: ABBVIE INC. ($88).

Total Amount

$215

General + Research + Ownership

Payments

13

Total payment records

General Amount

$215

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-25

Latest reported date

Top Companies

Largest payers in this snapshot

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes495474$0
83036Hemoglobin a1c level339322$0
84439Thyroxine (thyroid chemical), free221213$0
84443Blood test, thyroid stimulating hormone (tsh)219211$0
80053Blood test, comprehensive group of blood chemicals140139$0
View full utilization report →

Insurance plans in this area (ZIP 36301)

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Provider's Procedures

Unknown Individual performs procedures in Endocrinology, Diabetes & Metabolism Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ENDOCRINOLOGYAL76942Ultrasonic guidance imaging supervision and interpretation for insertion of needle2323
ENDOCRINOLOGYAL83036Hemoglobin A1C level1146572

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: 7416848247View full group profile
NameSpecialtyState
Nurse PractitionerAL
Nurse PractitionerAL
Internal MedicineAL
Nurse PractitionerAL
R H E U M A T O L O G YAL
Internal MedicineVA
Nurse PractitionerAL
Nurse PractitionerAL
Nurse PractitionerAL
Nurse PractitionerAL

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1851375679 on file in the registry.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Endocrinology, Diabetes & Metabolism Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Dothan?
Unknown Individual currently maps to Dothan, 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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