Unknown Individual – Family Medicine Physician, NPI 1093798522

Unknown Individual is a healthcare provider. based in Cumming, Georgia. specializing in Family Medicine Physician. They hold a License No. 037628 (GA). The NPI Number for Unknown Individual is 1093798522

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1093798522
Phone
(770) 781-8004
Address
1400 NORTHSIDE FORSYTH DR
Deactivation Date
11 November 2023

Doctor Profile

Medical School Name
UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Secondary Phone
7707818004
Graduation Year
1982 (44 years ago)
PAC ID
1951571389
Group Practice PAC ID
6709056138
Professional Enrollment ID
I20110823000403
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

  • Northside Forsyth Drive, Cumming, Forsyth County, Georgia, 30041, United States

    SUITE 200

    CUMMING, GA 300417668

    Phone: (770) 781-8004

    Fax: (678) 679-4053

    Type: Mailing

  • Cumming Park & Ride, Deputy Bill Cantrell Memorial Road, Forsyth County, Georgia, 30041, United States

    SUITE 150

    CUMMING, GA 30040

    Phone: (770) 781-8004

    Fax: (678) 679-4053

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 28 Open Payments records for all available years, with a total value of $454.

Total Amount is formed as General ($454) + Research ($0) + Ownership ($0) = $454.

Last reported payment date: 2023-08-24 • Largest payer in this snapshot: ABBVIE INC. ($147).

Total Amount

$454

General + Research + Ownership

Payments

28

Total payment records

General Amount

$454

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-08-24

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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
99214Established patient office or other outpatient visit, 30-39 minutes549450$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit260260$0
G0444Annual depression screening, 5 to 15 minutes194194$0
81003Automated urinalysis test185178$0
99213Established patient office or other outpatient visit, 20-29 minutes118114$0
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Insurance plans in this area (ZIP 30041)

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Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1093798522 uniquely identifies Unknown Individual in U.S. healthcare data.
Does inactive mean outdated data 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 Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Cumming, Georgia. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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