Unknown Individual – Chiropractor, NPI 1417110453

Unknown Individual is a healthcare provider. based in Rome, Georgia. specializing in Chiropractor. They hold a License No. CHIROO8374 (GA). The NPI Number for Unknown Individual is 1417110453

Main info

Organization
Inactive
18 Years Of Experience
Name
Unknown Individual
NPI
1417110453
Phone
(706) 234-7000
Address
PO BOX 1365
Deactivation Date
9 February 2021

Doctor Profile

Medical School Name
LIFE CHIROPRACTIC COLLEGE
Secondary Phone
7062347000
Graduation Year
2008 (18 years ago)
PAC ID
9032282066
Group Practice PAC ID
6608857404
Professional Enrollment ID
I20080723000705
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

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Provider Addresses for Unknown Individual

  • Il casale delle ginestre, 1365, Via del Casale di Sant'Angelo, Zona XLIX Santa Maria di Galeria, Municipio Roma XIV, Tragliatella, Fiumicino, Roma Capitale, Lazio, 00054, Italy

    ROME, GA 301621365

    Phone: (706) 234-7000

    Fax: (706) 234-2366

    Type: Mailing

  • 1011, North 5th Avenue, DeSoto Homes, Rome, Floyd County, Georgia, 30165, United States

    ROME, GA 301652601

    Phone: (706) 234-7000

    Fax: (706) 234-2366

    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 30162)

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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: 6608857404View full group profile
NameSpecialtyState
C H I R O P R A C T I CGA
C H I R O P R A C T I CGA
C H I R O P R A C T I CGA

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1417110453 — is the standard way to identify this listing.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Chiropractor. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Rome, Georgia in our summary view.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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