Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1083781694

Unknown Individual is a healthcare provider. based in Newnan, Georgia. specializing in Certified Registered Nurse Anesthetist. They hold a License No. RN110893 (GA). The NPI Number for Unknown Individual is 1083781694

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1083781694
Phone
(770) 251-2060
Address
PO BOX 73709
Deactivation Date
28 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2299246011
Graduation Year
1985 (41 years ago)
PAC ID
7517057615
Group Practice PAC ID
9436372323
Professional Enrollment ID
I20071213000024
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

  • PO BOX 73709

    NEWNAN, GA 302713709

    Phone: (770) 251-2060

    Fax: (678) 854-9235

    Type: Mailing

  • 80, Newnan Station Drive, Newnan, Coweta, Georgia, 30265, United States

    SUITE A

    NEWNAN, GA 30265

    Phone: (770) 251-2060

    Fax: (678) 854-9235

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
01938Anesthesia for injection, drainage or aspiration procedures on spine or spinal cord of lower back accessed through skin using imaging guidance9274$0
01810Anesthesia for procedure on nerves, muscles, tendons, and tissue of forearm, wrist, and hand3938$0
01480Anesthesia for other procedure on lower leg, ankle, and foot bones1515$0
View full utilization report →

Insurance plans in this area (ZIP 30271)

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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: 9436372323View full group profile
NameSpecialtyState
Anesthesiology, Pain ManagementGA
-GA
Certified Registered Nurse Anesthetist (Crna)GA
Certified Registered Nurse Anesthetist (Crna)GA
Pain Management, AnesthesiologyGA
Certified Registered Nurse Anesthetist (Crna)GA
Certified Registered Nurse Anesthetist (Crna)FL
Certified Registered Nurse Anesthetist (Crna)GA
Certified Registered Nurse Anesthetist (Crna)GA
Certified Registered Nurse Anesthetist (Crna)MI

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1083781694 for Unknown Individual, then check state licensing separately.
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?
Certified Registered Nurse Anesthetist is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Newnan, Georgia in our summary view.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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