Unknown Individual – Urology Physician, NPI 1053308262

Urology Physician

Unknown Individual is a healthcare provider. based in Brunswick, Georgia. specializing in Urology Physician. They hold a License No. 030848 (GA). The NPI Number for Unknown Individual is 1053308262

Main info

Organization

Inactive

56 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1053308262

Phone

(912) 265-1300

Address

2500 STARLING ST

Deactivation Date

18 September 2024

Doctor Profile

Medical School Name

OTHER

Secondary Phone

9122651300

Graduation Year

1970 (56 years ago)

PAC ID

2365454881

Group Practice PAC ID

9830093640

Professional Enrollment ID

I20120504000323

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

Renue Plastic Surgery, 2500, Starling Street, Brunswick, Glynn County, Georgia, 31520, United States
SUITE 602
BRUNSWICK, GA 315204219
Phone: (912) 265-1300
Fax: (912) 265-3580
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 31520)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 9830093640View full group profile

Name	Specialty	State
DR. PAULINE LAGGUI JACINTO (M.D.)	Infectious Disease	GA
SCOTT C CLAY (MD)	Family Practice	GA
KACEY MILLER (PA-C)	Physician Assistant	GA
DR. JOHN ALEXANDER LIMBURG (M.D.)	Family Practice	GA
MRS. REGINA SCHMIDT (PA-C)	Physician Assistant	GA
DR. CLAUDE LEVON III SANKS (M.D.)	Internal Medicine	GA
DR. MATTHEW D KATZ (MD)	-	GA
AVERY WADE STRICKLAND (M.D.)	Cardiovascular Disease (Cardiology), Internal Medicine	GA
NATALIE BENNETT YONZ	-	GA
ELIZABETH K WATSON (NP)	-	GA

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?

Public records show Unknown Individual under NPI 1053308262.

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.

What does the directory say Unknown Individual does?

Insurance directories may phrase it differently, but here Unknown Individual maps to Urology Physician. Clinical services aligned with this taxonomy classification.

What city is tied to Unknown Individual?

The directory associates Unknown Individual with Brunswick, Georgia. Check all listed addresses for suites or satellite offices.

Can I verify credentials using only NPI?

NPI confirms identity in the directory; licensure and board certification require separate checks.