Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1417288093

Unknown Individual is a healthcare provider. based in Augusta, Georgia. specializing in Certified Registered Nurse Anesthetist. They hold a License No. RN150012 (GA). The NPI Number for Unknown Individual is 1417288093

Main info

Organization
Inactive
17 Years Of Experience
Name
Unknown Individual
NPI
1417288093
Phone
(803) 278-2473
Address
2260 WRIGHTSBORO RD
Deactivation Date
19 June 2025

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Secondary Phone
7068559860
Graduation Year
2009 (17 years ago)
PAC ID
7113052291
Group Practice PAC ID
6204905763
Professional Enrollment ID
I20100315000407
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Trinity Hospital, 2260, Wrightsboro Road, Oglethorpe Homes, Augusta, Richmond County, Georgia, 30904, United States

    AUGUSTA, GA 309044764

    Phone: (803) 278-2473

    Type: Location

  • 3903, Beaver Brook Drive, Forest Creek, Martinez, Columbia County, Georgia, 30907, United States

    MARTINEZ, GA 309074167

    Phone: (706) 650-2053

    Type: Mailing

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
01402Anesthesia for procedure for total knee joint replacement4040$0
00811Anesthesia for other procedure on large bowel using an endoscope3231$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope2323$0
01638Anesthesia for open or endoscopic total shoulder joint replacement1515$0
00813Anesthesia for procedure on small and large bowel using an endoscope1515$0
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Insurance plans in this area (ZIP 30904)

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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: 6204905763View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)GA
Certified Registered Nurse Anesthetist (Crna)SC
Certified Registered Nurse Anesthetist (Crna)GA
Certified Registered Nurse Anesthetist (Crna)GA
A N E S T H E S I O L O G YGA
A N E S T H E S I O L O G YGA
A N E S T H E S I O L O G YMD
Certified Registered Nurse Anesthetist (Crna)GA
Certified Registered Nurse Anesthetist (Crna)GA
Certified Registered Nurse Anesthetist (Crna)GA

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1417288093.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Certified Registered Nurse Anesthetist for Unknown Individual. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Augusta, Georgia?
For routing, start with Augusta, Georgia for Unknown Individual, then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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