Unknown Individual – Women's Health Nurse Practitioner, NPI 1639254790

Unknown Individual is a healthcare provider. based in Thomasville, Georgia. specializing in Women's Health Nurse Practitioner. They hold a License No. 124327 (GA). The NPI Number for Unknown Individual is 1639254790

Main info

Organization
Inactive
31 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1639254790
Phone
(229) 226-8800
Address
916 S BROAD ST
Deactivation Date
14 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2292282000
Graduation Year
1995 (31 years ago)
PAC ID
7911078894
Group Practice PAC ID
3577839059
Professional Enrollment ID
I20080620000014
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

  • 916, South Broad Street, Fletcherville, Thomasville, Thomas County, Georgia, 31792, United States

    THOMASVILLE, GA 31792

    Phone: (229) 226-8800

    Fax: (229) 226-8232

    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 31792)

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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: 3577839059View full group profile

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1639254790.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Women's Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Thomasville, Georgia in the same public data insurers reference.
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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