Unknown Individual – Diagnostic Radiology Physician, NPI 1821069998

Unknown Individual is a healthcare provider. based in Panama city, Florida. specializing in Diagnostic Radiology Physician. They hold a License No. ME54829 (FL). The NPI Number for Unknown Individual is 1821069998

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1821069998
Phone
(850) 747-4905
Address
PO BOX 1770
Deactivation Date
7 August 2025

Doctor Profile

Medical School Name
UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Secondary Phone
8662827905827905
Graduation Year
1979 (47 years ago)
PAC ID
1658272679
Group Practice PAC ID
2466710306
Professional Enrollment ID
I20040114000163
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

  • 1770, Annabellas Drive, Panama City Beach, Bay County, Florida, 32407, United States

    PANAMA CITY, FL 32402

    Phone: (850) 747-4905

    Fax: (850) 747-4907

    Type: Mailing

  • 527, North Palo Alto Avenue, Panama City, Bay County, Florida, 32401, United States

    PANAMA CITY, FL 32401

    Phone: (850) 763-2451

    Fax: (850) 747-4907

    Type: Location

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 32402)

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Provider's Procedures

Unknown Individual performs procedures in Diagnostic Radiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYFL73562X-ray of knee, 3 views1717
DIAGNOSTIC RADIOLOGYFL73630X-ray of foot, minimum of 3 views4338
DIAGNOSTIC RADIOLOGYFL76830Ultrasound pelvis through vagina1312
DIAGNOSTIC RADIOLOGYFL93971Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers4040

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: 2466710306View full group profile
NameSpecialtyState
-OH
Diagnostic RadiologyDC
-TN
-OH
Interventional Radiology, Interventional Radiology, Diagnostic RadiologyFL
-FL
Diagnostic RadiologyPA
Diagnostic RadiologySC
-FL

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1821069998?
NPI 1821069998 belongs to Unknown Individual; compare other details if you need extra assurance.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Diagnostic Radiology Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Panama City, Florida.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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