Unknown Individual – Surgery Physician, NPI 1972590545

Unknown Individual is a healthcare provider. based in Albany, Georgia. specializing in Surgery Physician. They hold a License No. 20820 (GA). The NPI Number for Unknown Individual is 1972590545

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1972590545
Phone
(229) 434-4200
Address
605 N WESTOVER BLVD
Deactivation Date
1 July 2021

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Secondary Phone
2294344200
Graduation Year
1978 (48 years ago)
PAC ID
2769576370
Group Practice PAC ID
6305831090
Professional Enrollment ID
I20100830000576
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

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Provider Addresses for Unknown Individual

  • 605, North Westover Boulevard, Dawson Heights, Albany, Dougherty County, Georgia, 31707, United States

    ALBANY, GA 317072188

    Phone: (229) 434-4200

    Fax: (229) 434-4208

    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)

CMS reports 2 Open Payments records for all available years, with a total value of $49.

Total Amount is formed as General ($49) + Research ($0) + Ownership ($0) = $49.

Last reported payment date: 2023-09-19 • Largest payer in this snapshot: ABBVIE INC. ($33).

Total Amount

$49

General + Research + Ownership

Payments

2

Total payment records

General Amount

$49

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-19

Latest reported date

Top Companies

Largest payers in this snapshot

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31707)

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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: 6305831090View full group profile
NameSpecialtyState
General SurgerySC
General SurgeryGA
General SurgeryGA
General SurgeryGA
General SurgeryGA

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 1972590545.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Surgery Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Albany, Georgia in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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