Unknown Individual – Occupational Therapist, NPI 1154364297

Unknown Individual is a healthcare provider. based in Fortson, Georgia. specializing in Occupational Therapist. They hold a License No. OT001343 (GA). The NPI Number for Unknown Individual is 1154364297

Main info

Organization
Inactive
34 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1154364297
Phone
Not provided
Address
PO BOX 370
Deactivation Date
25 January 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7063246661
Graduation Year
1992 (34 years ago)
PAC ID
4880610096
Group Practice PAC ID
1355254780
Professional Enrollment ID
I20051018000601
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 370

    FORTSON, GA 318080370

    Phone:

    Fax: (706) 494-3008

    Type: Mailing

  • 6262, Veterans Parkway, Ogletree Woods, Columbus, Muscogee County, Georgia, 31909, United States

    COLUMBUS, GA 319093540

    Phone: (706) 324-6661

    Fax: (706) 327-6701

    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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31808)

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Provider's Procedures

Unknown Individual performs procedures in Occupational Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OCCUPATIONAL THERAPYGA97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes74480

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: 1355254780View full group profile
NameSpecialtyState
-GA
-AL
Physical Therapist In Private PracticeGA
Physician AssistantAL
Physical Therapist In Private PracticeGA
Sports Medicine, Orthopedic Surgery, Orthopedic SurgeryGA
Nurse PractitionerGA
Physical Therapist In Private PracticeSC
Sports Medicine, Orthopedic SurgeryGA
Occupational Therapist In Private PracticeGA

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1154364297.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Occupational Therapist. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Fortson, Georgia in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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