Unknown Individual – Undersea and Hyperbaric Medicine (Emergency Medicine) Physician, NPI 1558335208

Undersea and Hyperbaric Medicine (Emergency Medicine) Physician

Unknown Individual is a healthcare provider. based in Thomaston, Georgia. specializing in Undersea and Hyperbaric Medicine (Emergency Medicine) Physician. They hold a License No. 33624 (GA). The NPI Number for Unknown Individual is 1558335208

Main info

Organization

Inactive

38 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1558335208

Phone

Not provided

Address

255 GILBERT RD

Deactivation Date

30 January 2022

Doctor Profile

Medical School Name

MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE

Secondary Phone

7066922441

Graduation Year

1988 (38 years ago)

PAC ID

4688682651

Group Practice PAC ID

4183986490

Professional Enrollment ID

I20060404000390

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience28

Completeness75

Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

255 GILBERT RD
THOMASTON, GA 302861697
Phone:
Type: Mailing
2401 Newnan Crossing Blvd E Ste 100
Newnan, GA 302652409
Phone: (770) 400-7850
Type: Location
Athens Regional Medical Center, 1199, Prince Avenue, Normaltown, Athens, Athens-Clarke County, Georgia, 30606, United States
ATHENS, GA 306062797
Phone: (706) 475-2660
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.

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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.

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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 30286)

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Provider's Procedures

Unknown Individual performs procedures in Undersea and Hyperbaric Medicine (Emergency Medicine) Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
FAMILY MEDICINE	SC	11042	Removal of skin and tissue first 20 sq cm or less	111	60

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: 4183986490View full group profile

Name	Specialty	State
STEPHANIE GARRETT INTORCIA (APRN)	Nurse Practitioner	GA
MRS. JUDITH ANN TURNER (NP)	-	MN
GREGORY E EVANS (MD)	Critical Care (Intensivists)	GA
MR. DANIEL KLINER	Physician Assistant	GA
DR. ANTHONY KIMANI MWANGI (M.D.)	Pulmonary Disease, Critical Care (Intensivists)	GA
SANYA NIJHARA (PA-C)	Physician Assistant	GA
VIRGINIA ANN HORAN (PA-C)	-	UT
DR. ABRAHAM STEVEN MCINTOSH (M.D.)	G A S T R O E N T E R O L O G Y	GA
KATHLEEN GIARLA (NP)	-	GA
MR. SANDEEP ANAND (MMSC, PA-C)	-	GA

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?

The federal identifier for Unknown Individual is NPI 1558335208.

Is Unknown Individual's inactive status permanent?

An inactive NPI does not by itself prove someone stopped practicing — check other sources.

What field does Unknown Individual work in?

You can think of Unknown Individual as practicing within Undersea and Hyperbaric Medicine (Emergency Medicine) Physician. Clinical services aligned with this taxonomy classification.

Where is Unknown Individual's primary listing?

We display Thomaston, Georgia because that is what the record indicates for Unknown Individual.

How can I contact Unknown Individual?

Phone or fax may appear on the official NPI record when supplied — verify before relying on them.