Unknown Individual – Physical Therapist, NPI 1396714143

Unknown Individual is a healthcare provider. based in Meigs, Georgia. specializing in Physical Therapist. They hold a License No. PT006146 (GA). The NPI Number for Unknown Individual is 1396714143

Main info

Organization
Inactive
28 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1396714143
Phone
(229) 294-1346
Address
1012 HURST TATE RD
Deactivation Date
17 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2293361115
Graduation Year
1998 (28 years ago)
PAC ID
4183523517
Group Practice PAC ID
9234038662
Professional Enrollment ID
I20040108000068
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1012 HURST TATE RD

    MEIGS, GA 317653812

    Phone: (229) 294-1346

    Type: Mailing

  • 130, East Broad Street, Camilla, Mitchell County, Georgia, 31730, United States

    CAMILLA, GA 317301809

    Phone: (229) 336-1115

    Fax: (229) 336-1151

    Type: Location

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31765)

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Provider's Procedures

Unknown Individual performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYGA97001Physical therapy evaluation153141
PHYSICAL THERAPYGA97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes2150188
PHYSICAL THERAPYGA97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes20956

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: 9234038662View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
-GA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1396714143.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's primary classification?
Physical Therapist is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Meigs, Georgia may find Unknown Individual in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.