Unknown Individual – Nurse Practitioner, NPI 1659317089

Unknown Individual is a healthcare provider. based in Tuscaloosa, Alabama. specializing in Nurse Practitioner. They hold a License No. 1-047192 (AL). The NPI Number for Unknown Individual is 1659317089

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1659317089
Phone
(204) 633-3973
Address
4085 HEATHERSAGE CIR
Deactivation Date
17 July 2024
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

  • 4085, Heathersage Circle, Peach Grove, Tuscaloosa, Tuscaloosa County, Alabama, 35405, United States

    TUSCALOOSA, AL 354057775

    Phone: (204) 633-3973

    Fax: (205) 633-3973

    Type: Mailing

  • 1729, Pine Street, Oak Park, Montgomery, Montgomery County, Alabama, 36106, United States

    EMERGENCY ROOM C/O DR. STEVE O'MARA

    MONTGOMERY, AL 36105

    Phone: (335) 293-8040

    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 35405)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1659317089 if you need a stable reference for Unknown Individual.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Nurse Practitioner for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Tuscaloosa, Alabama for Unknown Individual; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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