Unknown Individual – Pulmonary Disease Physician, NPI 1205822251

Unknown Individual is a healthcare provider. based in Abingdon, Virginia. specializing in Pulmonary Disease Physician. They hold a License No. ME51259 (FL). The NPI Number for Unknown Individual is 1205822251

Main info

Organization
Inactive
43 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1205822251
Phone
(276) 619-3876
Address
24530 FALCON PLACE BLVD STE 101
Deactivation Date
17 May 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3055677080
Graduation Year
1983 (43 years ago)
PAC ID
7719946862
Group Practice PAC ID
1850360397
Professional Enrollment ID
I20041005001140
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

Provider Addresses for Unknown Individual

  • 24530 FALCON PLACE BLVD STE 101

    ABINGDON, VA 242117665

    Phone: (276) 619-3876

    Fax: (276) 619-3877

    Type: Location

  • Med Tech Parkway, Camelot Two, Johnson City, Washington County, East Tennessee, Tennessee, 37604, United States

    JOHNSON CITY, TN 376042579

    Phone: (423) 302-6565

    Fax: (423) 952-2175

    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 24211)

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Provider's Procedures

Unknown Individual performs procedures in Pulmonary Disease Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PULMONARY DISEASEFL78815Nuclear medicine study with CT imaging skull base to mid-thigh1111
PULMONARY DISEASEFL95811Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube4239

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: 1850360397View full group profile
NameSpecialtyState
Pulmonary DiseaseFL
Pulmonary Disease, Critical Care (Intensivists)FL
Pulmonary Disease, Critical Care (Intensivists)FL
Pulmonary Disease, Critical Care (Intensivists)FL
Critical Care (Intensivists), Pulmonary DiseaseFL
Critical Care (Intensivists)FL
Nurse PractitionerFL
Pulmonary DiseaseFL
Pulmonary DiseaseNY
Pulmonary DiseaseFL

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1205822251 in the public NPI dataset.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Pulmonary Disease Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Abingdon, Virginia as a primary anchor for Unknown Individual unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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