Unknown Individual – Family Medicine Physician, NPI 1386613537

Family Medicine Physician

Unknown Individual is a healthcare provider. based in Dallas, Georgia. specializing in Family Medicine Physician. They hold a License No. 16148 (GA). The NPI Number for Unknown Individual is 1386613537

Main info

Organization

Inactive

54 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1386613537

Phone

(770) 445-1095

Address

318 MAIN ST

Deactivation Date

10 April 2024

Doctor Profile

Medical School Name

R FRANKLIN UNIVERSITY OF MED & SCI/CHICAGO MEDICAL SCHOOL

Secondary Phone

Graduation Year

1972 (54 years ago)

PAC ID

3274720578

Professional Enrollment ID

I20101213000993

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

318, Main Street, Mountain Trace, Dallas, Paulding County, Georgia, 30132, United States
DALLAS, GA 301324266
Phone: (770) 445-1095
Fax: (770) 445-5361
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

HCPCS	Description	Services	Beneficiaries	Medicare allowed
99214	Established patient office or other outpatient visit, 30-39 minutes	728	85	$0
80305	Testing for presence of drug, read by direct observation	167	53	$0
96372	Injection of drug or substance under skin or into muscle	118	25	$0
J1040	Injection, methylprednisolone acetate, 80 mg	51	18	$0
99213	Established patient office or other outpatient visit, 20-29 minutes	47	24	$0

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Insurance plans in this area (ZIP 30132)

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Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?

Administrative and clinical systems typically use NPI 1386613537 for Unknown Individual.

What should I verify if Unknown Individual is listed inactive?

If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.

What does the directory say Unknown Individual does?

Insurance directories may phrase it differently, but here Unknown Individual maps to Family Medicine Physician. Clinical services aligned with this taxonomy classification.

Can patients visit Unknown Individual in Dallas, Georgia?

For routing, start with Dallas, Georgia for Unknown Individual, then verify phone and hours locally.

Can I export Unknown Individual's record?

You can download the official NPPES record; we summarize key fields for readability.