Unknown Individual – Hematology & Oncology Physician, NPI 1376718122

Unknown Individual is a healthcare provider. based in Warner robins, Georgia. specializing in Hematology & Oncology Physician. They hold a License No. 078101 (GA). The NPI Number for Unknown Individual is 1376718122

Main info

Organization
Inactive
19 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1376718122
Phone
(478) 287-6144
Address
114 Sutherlin Dr Ste C-1
Deactivation Date
27 January 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4782876144
Graduation Year
2007 (19 years ago)
PAC ID
9638361512
Group Practice PAC ID
0547247322
Professional Enrollment ID
I20170614002892
Data current as of
20 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

  • 114 Sutherlin Dr Ste C-1

    Warner Robins, GA 310882259

    Phone: (478) 287-6144

    Fax: (478) 287-6958

    Type: Location

  • 410, 1st Street, Macon, Bibb County, Georgia, 31201, United States

    MACON, GA 312018306

    Phone: (478) 743-7068

    Fax: (478) 741-1354

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 9 Open Payments records for all available years, with a total value of $172.

Total Amount is formed as General ($172) + Research ($0) + Ownership ($0) = $172.

Last reported payment date: 2024-08-25 • Largest payer in this snapshot: ABBVIE INC. ($87).

Total Amount

$172

General + Research + Ownership

Payments

9

Total payment records

General Amount

$172

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-25

Latest reported date

Top Companies

Largest payers in this snapshot

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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.

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 31088)

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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: 0547247322View full group profile

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1376718122; it appears in the national provider directory.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Hematology & Oncology Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Warner Robins, Georgia because that is what the record indicates for Unknown Individual.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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