Unknown Individual – Occupational Medicine Physician, NPI 1215928205

Unknown Individual is a healthcare provider. based in Fort rucker, Alabama. specializing in Occupational Medicine Physician. They hold a License No. 34949 (MO). The NPI Number for Unknown Individual is 1215928205

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1215928205
Phone
(334) 255-7387
Address
301 ANDREWS AVENUE
Deactivation Date
1 March 2022
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

  • Lyster Army Health Clinic, 301, Andrews Avenue, Dale County, Alabama, 36362, United States

    LYSTER ARMY HEALTH CLINIC

    FORT RUCKER, AL 36362

    Phone: (334) 255-7387

    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.

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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 36362)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1215928205.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's primary classification?
Occupational Medicine Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Fort Rucker, Alabama in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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