Unknown Individual – Cardiovascular Disease Physician, NPI 1487658472

Unknown Individual is a healthcare provider. based in Palm coast, Florida. specializing in Cardiovascular Disease Physician. They hold a License No. 22797 (GA). The NPI Number for Unknown Individual is 1487658472

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1487658472
Phone
(386) 586-1800
Address
61 MEMORIAL MEDICAL PKWY
Deactivation Date
6 December 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Memorial Medical Parkway, Palm Coast, Flagler County, Florida, 32164, United States

    SUITE 2811

    PALM COAST, FL 321645981

    Phone: (386) 586-1800

    Fax: (386) 586-1898

    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 32164)

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Provider's Procedures

Unknown Individual performs procedures in Cardiovascular Disease Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)FL93280Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report2220
CARDIOVASCULAR DISEASE (CARDIOLOGY)FL93458Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart130126

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1487658472.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Cardiovascular Disease Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Palm Coast, Florida in registry-derived data.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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