Unknown Individual – Family Medicine Physician, NPI 1629079074

Unknown Individual is a healthcare provider. based in Pensacola, Florida. specializing in Family Medicine Physician. They hold a License No. 00024683 (AL). The NPI Number for Unknown Individual is 1629079074

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1629079074
Phone
(125) 652-7345
Address
14 W JORDAN ST
Deactivation Date
23 January 2025
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

  • 14, West Jordan Street, Pensacola, Escambia County, Florida, 32501, United States

    PENSACOLA, FL 325011736

    Phone: (125) 652-7345

    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.

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 32501)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1629079074?
NPI 1629079074 belongs to Unknown Individual; compare other details if you need extra assurance.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Pensacola, Florida as the reference point for Unknown Individual, then confirm.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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