Unknown Individual – Orthopaedic Hand Surgery Physician, NPI 1558358051

Unknown Individual is a healthcare provider. based in Roswell, Georgia. specializing in Orthopaedic Hand Surgery Physician. They hold a License No. 023613 (GA). The NPI Number for Unknown Individual is 1558358051

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1558358051
Phone
(770) 475-2710
Address
1285 HEMBREE RD
Deactivation Date
9 January 2025

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF WISCONSIN
Secondary Phone
4048479999
Graduation Year
1976 (50 years ago)
PAC ID
7810056942
Group Practice PAC ID
1153224142
Professional Enrollment ID
I20081105000031
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

  • 1285, Hembree Road, Roswell, Fulton County, Georgia, 30076, United States

    SUITE 200-A

    ROSWELL, GA 300765720

    Phone: (770) 475-2710

    Fax: (770) 360-0498

    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 30076)

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Provider's Procedures

Unknown Individual performs procedures in Orthopaedic Hand Surgery Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
HAND SURGERYGA20610Aspiration and/or injection of large joint or joint capsule1912
HAND SURGERYGA64721Release and/or relocation of median nerve of hand2017
HAND SURGERYGA73110X-ray of wrist, minimum of 3 views163103
HAND SURGERYGA73140X-ray of fingers, minimum of 2 views9467

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: 1153224142View full group profile
NameSpecialtyState
-GA
Physical Therapist In Private PracticeGA
Physician AssistantGA
-GA
Diagnostic RadiologyGA
Physical Therapist In Private PracticeGA
Occupational Therapist In Private PracticeNJ
Nurse PractitionerGA
-GA
-GA

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1558358051 on file in the registry.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Orthopaedic Hand Surgery Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Roswell?
Public fields place Unknown Individual around Roswell, Georgia. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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