Unknown Individual – Internal Medicine Physician, NPI 1164472197

Unknown Individual is a healthcare provider. based in Metter, Georgia. specializing in Internal Medicine Physician. They hold a License No. 044594 (GA). The NPI Number for Unknown Individual is 1164472197

Main info

Organization
Inactive
34 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1164472197
Phone
(912) 685-6403
Address
400 Cedar St
Deactivation Date
19 April 2023

Doctor Profile

Medical School Name
NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Secondary Phone
-
Graduation Year
1992 (34 years ago)
PAC ID
8820038797
Professional Enrollment ID
I20050510000757
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

Provider Addresses for Unknown Individual

  • 400 Cedar St

    Metter, GA 304393338

    Phone: (912) 685-6403

    Type: Location

  • 740, East General Stewart Way, Garden Acres, Hinesville, Liberty County, Georgia, 31313, United States

    SUITE 103

    HINESVILLE, GA 313132634

    Phone: (912) 876-5452

    Fax: (912) 876-5834

    Type: Mailing

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.

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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.

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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 minutes1717$0
99284Emergency department visit with moderate level of medical decision making1515$0
99213Established patient office or other outpatient visit, 20-29 minutes1311$0
View full utilization report →

Insurance plans in this area (ZIP 30439)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1164472197 if you need a stable reference for Unknown Individual.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Metter, Georgia for Unknown Individual; download NPPES for the complete set.
What if Metter, Georgia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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