Unknown Individual – Family Medicine Physician, NPI 1992771505

Unknown Individual is a healthcare provider. based in Demopolis, Alabama. specializing in Family Medicine Physician. They hold a License No. 3176 (AL). The NPI Number for Unknown Individual is 1992771505

Main info

Organization
Inactive
64 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1992771505
Phone
(334) 289-1154
Address
203 US HIGHWAY 80 W
Deactivation Date
30 January 2022

Doctor Profile

Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Secondary Phone
3342891517
Graduation Year
1962 (64 years ago)
PAC ID
4688616352
Group Practice PAC ID
6709873235
Professional Enrollment ID
I20050816001074
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

  • County Highway 21, Demopolis, Marengo County, Alabama, 36732, United States

    P. O. BOX 935

    DEMOPOLIS, AL 367324103

    Phone: (334) 289-1154

    Fax: (334) 289-8353

    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 36732)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEAL20610Aspiration and/or injection of large joint or joint capsule14660
FAMILY MEDICINEAL83036Hemoglobin A1C level436240
FAMILY MEDICINEAL85610Blood test, clotting time17444
FAMILY MEDICINEAL92567Eardrum testing using ear probe3329
FAMILY MEDICINEAL93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report317275
FAMILY MEDICINEAL94060Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration5631

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: 6709873235View full group profile
NameSpecialtyState
Nurse PractitionerAL
-AL
-AL
-AL
Certified Registered Nurse Anesthetist (Crna)MS
Obstetrics/Gynecology, Family PracticeAL
General Practice, Emergency MedicineAL
Nurse PractitionerAL
Interventional Cardiology, Cardiovascular Disease (Cardiology)AL
Nurse PractitionerAL

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1992771505.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Family Medicine Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Demopolis, Alabama; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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