Unknown Individual – Diagnostic Radiology Physician, NPI 1497733703

Unknown Individual is a healthcare provider. based in Germantown, Tennessee. specializing in Diagnostic Radiology Physician. They hold a License No. 56116 (TN). The NPI Number for Unknown Individual is 1497733703

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1497733703
Phone
(901) 683-0055
Address
7945 WOLF RIVER BLVD
Deactivation Date
27 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9016830055
Graduation Year
1980 (46 years ago)
PAC ID
3173514502
Group Practice PAC ID
2668360579
Professional Enrollment ID
I20190125002238
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 7945, Wolf River Boulevard, Germantown, Shelby County, Tennessee, 38138, United States

    GERMANTOWN, TN 381381762

    Phone: (901) 683-0055

    Fax: (901) 685-2969

    Type: Location

  • Poplar Avenue, Forest Hill, Germantown, Shelby County, Tennessee, 38139, United States

    GERMANTOWN, TN 381383941

    Phone: (901) 683-0055

    Fax: (901) 685-2969

    Type: Mailing

  • 602 Indiana Ave

    Lubbock, TX 794153364

    Phone: (806) 761-0878

    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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0279Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)399397$0
77066Diagnostic mammography of both breasts303303$0
77063Screening 3d breast mammography286286$0
77067Screening mammography286286$0
77065Diagnostic mammography of 1 breast9696$0
View full utilization report →

Insurance plans in this area (ZIP 38138)

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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: 2668360579View full group profile
NameSpecialtyState
Nurse PractitionerTN
Nurse PractitionerTN
-TN
-TN
Nurse PractitionerTN
Physician AssistantTN
Hematology/Oncology, Internal MedicineTN
-TN
-TN
H E M A T O L O G Y/ O N C O L O G YTN

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1497733703?
NPI 1497733703 belongs to Unknown Individual; compare other details if you need extra assurance.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
Where in Tennessee is Unknown Individual registered?
Use Germantown, Tennessee as the headline location for Unknown Individual here.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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