Unknown Individual – Cardiovascular Disease Physician, NPI 1255307583

Unknown Individual is a healthcare provider. based in Athens, Georgia. specializing in Cardiovascular Disease Physician. They hold a License No. 029163 (GA). The NPI Number for Unknown Individual is 1255307583

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1255307583
Phone
(706) 208-9700
Address
2005 PRINCE AVE
Deactivation Date
12 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7064858495
Graduation Year
1980 (46 years ago)
PAC ID
0749174001
Group Practice PAC ID
0446265185
Professional Enrollment ID
I20040811000353
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

  • 2005, Prince Avenue, Normaltown, Athens, Athens-Clarke County, Georgia, 30606, United States

    ATHENS, GA 306066032

    Phone: (706) 208-9700

    Fax: (706) 208-0878

    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
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes3919$0
99214Established patient office or other outpatient visit, 30-39 minutes1514$0
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Insurance plans in this area (ZIP 30606)

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Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1255307583; it appears in the national provider directory.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Cardiovascular Disease Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Athens, Georgia for Unknown Individual based on available NPPES addresses.
What if Athens, Georgia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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