Unknown Individual – Emergency Medicine Physician, NPI 1740353507

Unknown Individual is a healthcare provider. based in Brunswick, Georgia. specializing in Emergency Medicine Physician. They hold a License No. 019081 (GA). The NPI Number for Unknown Individual is 1740353507

Main info

Organization
Inactive
59 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1740353507
Phone
(912) 466-5800
Address
PO BOX 1213
Deactivation Date
8 January 2026

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
9124665400
Graduation Year
1967 (59 years ago)
PAC ID
6507898434
Group Practice PAC ID
9830093640
Professional Enrollment ID
I20051130000361
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 1213, 110, Wicklow Parish, Carleton County, New Brunswick, E7K 2E1, Canada

    BRUNSWICK, GA 315211213

    Phone: (912) 466-5800

    Fax: (912) 265-1524

    Type: Mailing

  • 3400 PARKWOOD DR

    BRUNSWICK, GA 315204755

    Phone: (912) 466-5800

    Fax: (912) 265-1524

    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.

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes406366$0
36415Insertion of needle into vein for collection of blood sample402335$0
99214Established patient office or other outpatient visit, 30-39 minutes152146$0
J1100Injection, dexamethasone sodium phosphate, 1 mg14814$0
87880Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)120118$0
View full utilization report →

Insurance plans in this area (ZIP 31521)

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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: 9830093640View full group profile
NameSpecialtyState
Infectious DiseaseGA
Family PracticeGA
Physician AssistantGA
Family PracticeGA
Physician AssistantGA
Internal MedicineGA
-GA
Cardiovascular Disease (Cardiology), Internal MedicineGA
-GA
-GA

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1740353507 as the unique 10-digit identifier.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Brunswick, Georgia as the reference point for Unknown Individual, then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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