Unknown Individual – Family Medicine Physician, NPI 1306838974

Unknown Individual is a healthcare provider. based in Jesup, Georgia. specializing in Family Medicine Physician. They hold a License No. 051471 (GA). The NPI Number for Unknown Individual is 1306838974

Main info

Organization
Inactive
27 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1306838974
Phone
(912) 427-7400
Address
825 S 1ST ST
Deactivation Date
20 June 2022

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1999 (27 years ago)
PAC ID
5890895940
Professional Enrollment ID
I20070703000292
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

Loading map...

Provider Addresses for Unknown Individual

  • South 1st Street, Jesup, Wayne County, Georgia, 31545, United States

    P. O. BOX 606

    JESUP, GA 315450209

    Phone: (912) 427-7400

    Fax: (912) 385-2953

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $21.

Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.

Last reported payment date: 2024-04-15 • Largest payer in this snapshot: Boston Scientific Corporation ($21).

Total Amount

$21

General + Research + Ownership

Payments

1

Total payment records

General Amount

$21

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-15

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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 31545)

Loading plans...

Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEGA81002Urinalysis, manual test3425

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I cross-check Unknown Individual using NPI 1306838974?
NPI 1306838974 belongs to Unknown Individual; compare other details if you need extra assurance.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Jesup, Georgia.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

Similar Providers

DR. RANDY LENTZ (M.D.)

Family Medicine Physician
Sunset Boulevard, Jesup, Wayne County, Georgia, 31545, United States
NPI: 1205832227

KEVIN O. KEOWN (M.D.)

Family Medicine Physician
118 AZALEA RD STE 1
NPI: 1083606800

ROBERT L. PHILLIPS (M.D.)

Family Medicine Physician
Peachtree Street, Jesup, Wayne County, Georgia, 31545, United States
NPI: 1831181403

DR. DANIEL JOSEPH GREEN (M.D.)

Family Medicine Physician
865, 1st Street, Jesup, Buchanan County, Iowa, 50648, United States
NPI: 1336130111

DR. DOROTHY KAREN NELDER (M.D.)

Family Medicine Physician
Peachtree Street, Jesup, Wayne County, Georgia, 31545, United States
NPI: 1285695338

Wayne Obstetrics and Gynecology

Obstetrics & Gynecology Physician
PO BOX 604
NPI: 1285696112
111 17th Ave E
NPI: 1801850094
PO BOX 937
NPI: 1114962487

KEVIN T BROWN (DO)

Family Medicine Physician
4300 N POINT PKWY STE 300
NPI: 1841204377