Unknown Individual – Physical Therapist, NPI 1497793988

Unknown Individual is a healthcare provider. based in Palm coast, Florida. specializing in Physical Therapist. They hold a License No. PT22525 (FL). The NPI Number for Unknown Individual is 1497793988

Main info

Organization
Inactive
21 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1497793988
Phone
(386) 446-4101
Address
520 PALM COAST PKWY SW
Deactivation Date
17 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3864470610
Graduation Year
2005 (21 years ago)
PAC ID
4082624507
Group Practice PAC ID
9739197872
Professional Enrollment ID
I20060428000119
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

  • 520, Palm Coast Parkway Southwest, Palm Coast, Flagler County, Florida, 32137, United States

    SUITE 101

    PALM COAST, FL 321374742

    Phone: (386) 446-4101

    Fax: (386) 447-2161

    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 32137)

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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: 9739197872View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1497793988 when you need to reference Unknown Individual in forms, claims, or directories.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Physical Therapist. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Palm Coast, Florida for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1497793988. Always confirm identity and privileges with the practice and licensing boards.

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