Unknown Individual – Pediatrics Physician, NPI 1457481731

Unknown Individual is a healthcare provider. based in Toccoa, Georgia. specializing in Pediatrics Physician. They hold a License No. 023574 (GA). The NPI Number for Unknown Individual is 1457481731

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1457481731
Phone
(706) 886-8419
Address
58 BIG A RD
Deactivation Date
31 May 2022

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Secondary Phone
7709431636
Graduation Year
1980 (46 years ago)
PAC ID
9133361116
Group Practice PAC ID
8426949587
Professional Enrollment ID
I20150318002434
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

Provider Addresses for Unknown Individual

  • 58 BIG A RD

    TOCCOA, GA 305776017

    Phone: (706) 886-8419

    Fax: (706) 827-5083

    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.

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

Insurance plans in this area (ZIP 30577)

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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: 8426949587View full group profile
NameSpecialtyState
Internal MedicineGA
Family PracticeGA
Family PracticeGA
-GA
Family Practice, Emergency MedicineGA
Family PracticeGA
Cardiovascular Disease (Cardiology), Internal MedicineKY
Family PracticeGA
Cardiovascular Disease (Cardiology)GA
Internal MedicineGA

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1457481731.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Pediatrics Physician. Clinical services aligned with this taxonomy classification.
Where in Georgia is Unknown Individual registered?
Use Toccoa, Georgia as the headline location for Unknown Individual here.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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