Unknown Individual – Family Medicine Physician, NPI 1174524805
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
632, Ferncrest Drive, North Harris Street Historic District, Sandersville, Washington County, Georgia, 31082, United States
SANDERSVILLE, GA 310821863
Phone: (478) 552-9000
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $125.
Total Amount is formed as General ($125) + Research ($0) + Ownership ($0) = $125.
Last reported payment date: 2023-03-23 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($125).
Total Amount
$125
General + Research + Ownership
Payments
1
Total payment records
General Amount
$125
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $125 |
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 121 | 109 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 111 | 109 | $0 |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 65 | 65 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 49 | 49 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 49 | 49 | $0 |
Insurance plans in this area (ZIP 31082)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | SC | |
| - | NC | |
| Family Practice | SC | |
| Family Practice, General Practice | SC | |
| Physician Assistant | SC | |
| - | TN | |
| - | SC | |
| Physician Assistant | SC | |
| - | SC | |
| - | SC |
Reviews
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