Unknown Individual – Interventional Pain Medicine Physician, NPI 1619958790

Unknown Individual is a healthcare provider. based in Athens, Georgia. specializing in Interventional Pain Medicine Physician. They hold a License No. 37199 (GA). The NPI Number for Unknown Individual is 1619958790

Main info

Organization
Inactive
34 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1619958790
Phone
(706) 549-8114
Address
1620 PRINCE AVE
Deactivation Date
30 January 2025

Doctor Profile

Medical School Name
MOREHOUSE SCHOOL OF MEDICINE
Secondary Phone
7095498114
Graduation Year
1992 (34 years ago)
PAC ID
3678467883
Group Practice PAC ID
8123912326
Professional Enrollment ID
I20110104000784
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

  • 1620, Prince Avenue, Normaltown, Athens, Athens-Clarke County, Georgia, 30606, United States

    ATHENS, GA 306066008

    Phone: (706) 549-8114

    Fax: (706) 549-0151

    Type: Location

  • Box, 4, Κωλέττη, Exarcheia, Athens, Municipality of Athens, Regional Unit of Central Athens, Attica, 106 81, Greece

    ATHENS, GA 306080883

    Phone: (706) 549-8114

    Fax: (706) 549-0151

    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.

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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 30606)

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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: 8123912326View full group profile

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1619958790 uniquely identifies Unknown Individual in U.S. healthcare data.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
How should patients interpret Unknown Individual's specialty?
The extract shows Interventional Pain Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Athens, Georgia?
For routing, start with Athens, 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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