Unknown Individual – Neurological Surgery Physician, NPI 1962572123

Neurological Surgery Physician

Unknown Individual is a healthcare provider. based in Thomasville, Georgia. specializing in Neurological Surgery Physician. They hold a License No. 32907 (GA). The NPI Number for Unknown Individual is 1962572123

Main info

Organization

Inactive

45 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1962572123

Phone

Not provided

Address

900 CAIRO RD

Deactivation Date

21 June 2022

Doctor Profile

Medical School Name

GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE

Secondary Phone

2292268880

Graduation Year

1981 (45 years ago)

PAC ID

3375582562

Group Practice PAC ID

8123196383

Professional Enrollment ID

I20050427000699

Contacts

Secure Messaging

craig.fredericks.p24@direct.archbold.nextgenshare.com

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness85

Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

900, Cairo Road, Booker Heights, Thomasville, Thomas County, Georgia, 31792, United States
THOMASVILLE, GA 317924255
Phone:
Type: Mailing
Archbold Neurosurgery Services, 704, South Broad Street, Fletcherville, Thomasville, Thomas County, Georgia, 31792, United States
THOMASVILLE, GA 317926107
Phone: (229) 226-8880
Fax: (229) 226-6423
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.

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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Provider's Procedures

Unknown Individual performs procedures in Neurological Surgery Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
NEUROSURGERY	GA	63048	Partial removal of spine bone with release of spinal cord and/or nerves	40	24
NEUROSURGERY	GA	64493	Injections of lower or sacral spine facet joint using imaging guidance	15	12

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: 8123196383View full group profile

Name	Specialty	State
CECILIE COWIE (NP)	Nurse Practitioner	GA
LOUIS G LEE (M.D.)	-	GA
DR. JASON E GRIFFIN (M.D.)	Family Practice	GA
DR. SHEETAL L HIGBEE (M.D.)	H E M A T O L O G Y/ O N C O L O G Y	GA
SHAY BLANTON SCHIE (NP)	-	GA
JOHNNY M BELENCHIA (MD)	-	GA
DR. ADEWOLE COLLINS LONGE (M.D.)	-	GA
JESSICA LYNN SMITH (NP-C)	Nurse Practitioner	GA
DR. GREGORY K PATTERSON (MD)	General Surgery	GA
JESSICA BROWN (NP)	Nurse Practitioner	GA

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?

NPI 1962572123 is assigned to Unknown Individual under the national enumeration system.

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 Neurological Surgery Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.

What location metadata exists for Unknown Individual?

The page summarizes Thomasville, Georgia for Unknown Individual; expand the address list for detail.

Does Medicare enrollment show here?

Medicare enrollment screens are separate from the basic NPI extract shown here.