Unknown Individual – Adult Medicine Physician, NPI 1790886778

Unknown Individual is a healthcare provider. based in Columbus, Georgia. specializing in Adult Medicine Physician. They hold a License No. 59887 (GA). The NPI Number for Unknown Individual is 1790886778

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1790886778
Phone
(706) 660-9509
Address
11 STONEWOOD CT
Deactivation Date
5 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7063211223
Graduation Year
1981 (45 years ago)
PAC ID
2769547561
Group Practice PAC ID
4981957032
Professional Enrollment ID
I20090211000294
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:0State licenses:3Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 11, Stonewood Court, Brookstone, Columbus, Muscogee County, Georgia, 31904, United States

    COLUMBUS, GA 319042966

    Phone: (706) 660-9509

    Type: Mailing

  • 7269, Stillwater Drive, Columbus, Muscogee County, Georgia, 31904, United States

    COLUMBUS, GA 319041959

    Phone: (706) 544-1730

    Fax: (706) 544-1090

    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 $16.

Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.

Last reported payment date: 2023-06-22 • Largest payer in this snapshot: Novo Nordisk Inc ($16).

Total Amount

$16

General + Research + Ownership

Payments

1

Total payment records

General Amount

$16

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-06-22

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Novo Nordisk Inc$16
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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes19228$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes18933$0
99213Established patient office or other outpatient visit, 20-29 minutes2415$0
99214Established patient office or other outpatient visit, 30-39 minutes1411$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes1313$0
View full utilization report →

Insurance plans in this area (ZIP 31904)

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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: 4981957032View full group profile
NameSpecialtyState
Physician AssistantGA
Emergency MedicineGA
Emergency MedicineCA

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1790886778 if you need a stable reference for Unknown Individual.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Adult Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Columbus, Georgia for Unknown Individual; expand the address list for detail.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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