Unknown Individual – Anesthesiology Physician, NPI 1558357715

Unknown Individual is a healthcare provider. based in Atlanta, Georgia. specializing in Anesthesiology Physician. They hold a License No. 019235 (GA). The NPI Number for Unknown Individual is 1558357715

Main info

Organization
Inactive
51 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1558357715
Phone
(800) 919-1190
Address
PO BOX 102186
Deactivation Date
6 November 2025

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Secondary Phone
7065065000
Graduation Year
1975 (51 years ago)
PAC ID
7911949193
Group Practice PAC ID
0840338018
Professional Enrollment ID
I20050527000090
Data current as of
19 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

  • PO BOX 102186

    ATLANTA, GA 303682186

    Phone: (800) 919-1190

    Fax: (706) 737-2271

    Type: Mailing

  • 330, Turner McCall Boulevard, DeSoto Homes, Rome, Floyd County, Georgia, 30165, United States

    ROME, GA 301655630

    Phone: (706) 802-2000

    Fax: (706) 233-9846

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $39.

Total Amount is formed as General ($39) + Research ($0) + Ownership ($0) = $39.

Last reported payment date: 2024-11-06 • Largest payer in this snapshot: GENZYME CORPORATION ($39).

Total Amount

$39

General + Research + Ownership

Payments

1

Total payment records

General Amount

$39

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-06

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
GENZYME CORPORATION$39
View all Open Payments →|Open Payments Risk Radar →

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 30368)

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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: 0840338018View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YGA
Certified Registered Nurse Anesthetist (Crna)KY
Certified Registered Nurse Anesthetist (Crna)GA
Anesthesiology AssistantMO
-GA
Certified Registered Nurse Anesthetist (Crna)FL
-GA
Anesthesiology AssistantGA
-FL
Certified Registered Nurse Anesthetist (Crna)GA

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1558357715 — is the standard way to identify this listing.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Atlanta, 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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