Unknown Individual – Internal Medicine Physician, NPI 1194713735

Unknown Individual is a healthcare provider. based in Covington, Georgia. specializing in Internal Medicine Physician. They hold a License No. 031515 (GA). The NPI Number for Unknown Individual is 1194713735

Main info

Organization
Inactive
39 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1194713735
Phone
(770) 787-4700
Address
4181 HOSPITAL DR NE
Deactivation Date
29 April 2023

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Secondary Phone
4047286812
Graduation Year
1987 (39 years ago)
PAC ID
8628093291
Group Practice PAC ID
3476559782
Professional Enrollment ID
I20100623000043
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

  • Hospital Drive Northeast, Covington, Newton County, Georgia, 30015, United States

    STE 401

    COVINGTON, GA 300142541

    Phone: (770) 787-4700

    Fax: (770) 784-0435

    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)

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes9491$0
99213Established patient office or other outpatient visit, 20-29 minutes2322$0
83036Hemoglobin a1c level1818$0
View full utilization report →

Insurance plans in this area (ZIP 30014)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEGA85610Blood test, clotting time17919

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: 3476559782View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)GA
Anesthesiology AssistantGA
Certified Registered Nurse Anesthetist (Crna)GA
Internal Medicine, Infectious DiseaseGA
-GA
-GA
Physician AssistantGA
Certified Registered Nurse Anesthetist (Crna)FL
N E U R O L O G YGA

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1194713735.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Internal Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Covington, Georgia as a primary anchor for Unknown Individual unless the record lists multiple sites.
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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