Unknown Individual – Family Medicine Physician, NPI 1508882671

Unknown Individual is a healthcare provider. based in Lewisburg, Tennessee. specializing in Family Medicine Physician. They hold a License No. MD007988 (TN). The NPI Number for Unknown Individual is 1508882671

Main info

Organization
Inactive
53 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1508882671
Phone
(931) 359-3551
Address
304 W CHURCH ST
Deactivation Date
24 August 2022

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
1973 (53 years ago)
PAC ID
4880670637
Professional Enrollment ID
I20070619000680
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

  • 304, West Church Street, Marshall Heights, Lewisburg, Marshall County, Tennessee, 37091, United States

    LEWISBURG, TN 37091

    Phone: (931) 359-3551

    Fax: (931) 359-8421

    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 37091)

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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 MEDICINETN81002Urinalysis, manual test4230

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1508882671.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Lewisburg, Tennessee?
For routing, start with Lewisburg, Tennessee for Unknown Individual, then verify phone and hours locally.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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