Unknown Individual – Registered Nurse, NPI 1053648113

Unknown Individual is a healthcare provider. based in Guntersville, Alabama. specializing in Registered Nurse. They hold a License No. 1-066210 (AL). The NPI Number for Unknown Individual is 1053648113

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1053648113
Phone
(256) 582-3203
Address
2409 HOMER CLAYTON DR
Deactivation Date
13 October 2023
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Mountain Lakes Behavioral Healthcare, 2409, Homer Clayton Drive, Mill Village, Guntersville, Marshall County, Alabama, 35976, United States

    GUNTERSVILLE, AL 359762207

    Phone: (256) 582-3203

    Fax: (256) 582-3216

    Type: Mailing

  • Highway 401, Dutton/Dunwich, Elgin County, Southwestern Ontario, Ontario, N0L 1J0, Canada

    DUTTON, AL 357447330

    Phone: (256) 228-6514

    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 35976)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1053648113 for Unknown Individual, then check state licensing separately.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Registered Nurse. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Guntersville, Alabama 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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