Unknown Individual – Family Medicine Physician, NPI 1124090030
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Albany Post Office, West Broad Avenue, Hollywood, Albany, Dougherty County, Georgia, 31701, United States
ALBANY, GA 317022548
Phone: (229) 312-5800
Fax: (229) 312-5853
Type: Mailing
Old Georgia Highway 3, Camilla, Mitchell County, Georgia, 31730, United States
CAMILLA, GA 31730
Phone: (229) 883-4297
Fax: (229) 336-8200
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 41 Open Payments records for all available years, with a total value of $726.
Total Amount is formed as General ($726) + Research ($0) + Ownership ($0) = $726.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($220).
Total Amount
$726
General + Research + Ownership
Payments
41
Total payment records
General Amount
$726
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $220 |
| Dexcom, Inc. | $181 |
| Novo Nordisk Inc | $124 |
| ABBVIE INC. | $35 |
| Merck Sharp & Dohme LLC | $32 |
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 330 | 140 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 226 | 131 | $0 |
| 82962 | Blood glucose (sugar) test performed by hand-held instrument | 145 | 53 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 83 | 83 | $0 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 68 | 12 | $0 |
Insurance plans in this area (ZIP 31702)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | GA | 81002 | Urinalysis, manual test | 45 | 36 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | GA | |
| Nurse Practitioner | GA | |
| - | GA | |
| Internal Medicine | GA | |
| - | GA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Internal Medicine, Critical Care (Intensivists), Infectious Disease | IN | |
| Internal Medicine | GA | |
| Internal Medicine | GA | |
| Pulmonary Disease, Internal Medicine | FL |
Reviews
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