Unknown Individual – Family Medicine Physician, NPI 1871594630

Unknown Individual is a healthcare provider. based in Winfield, Tennessee. specializing in Family Medicine Physician. They hold a License No. 43696 (KY). The NPI Number for Unknown Individual is 1871594630

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1871594630
Phone
(423) 569-8064
Address
25677 SCOTT HWY
Deactivation Date
13 September 2021

Doctor Profile

Medical School Name
TUFTS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
4236639200
Graduation Year
1982 (44 years ago)
PAC ID
0143121731
Group Practice PAC ID
7517945678
Professional Enrollment ID
I20040116000399
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 25677, Scott Highway, Isham, Winfield, Scott County, Tennessee, 37892, United States

    WINFIELD, TN 378922293

    Phone: (423) 569-8064

    Fax: (423) 569-2461

    Type: Location

  • 470, Industrial Lane, West Oneida, Oneida, Scott County, Tennessee, 37841, United States

    ONEIDA, TN 378416294

    Phone: (423) 286-4141

    Fax: (423) 286-4145

    Type: Mailing

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 37892)

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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
INTERNAL MEDICINETN82270Stool analysis for blood to screen for colon tumors1313

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: 7517945678View full group profile
NameSpecialtyState
Nurse PractitionerTN
Physician AssistantTN
Family PracticeTN
Internal Medicine, Pediatric MedicinePA
-TN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Family PracticePA
Physician AssistantTN

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1871594630 for Unknown Individual, then check state licensing separately.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Winfield, Tennessee in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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