Unknown Individual – Family Medicine Physician, NPI 1003920901

Unknown Individual is a healthcare provider. based in Martinez, Georgia. specializing in Family Medicine Physician. They hold a License No. 10977A (GA). The NPI Number for Unknown Individual is 1003920901

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1003920901
Phone
(706) 863-7155
Address
210 OAK ST
Deactivation Date
1 May 2025
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

  • 210, Oak Street, Casa Linda, Martinez, Columbia County, Georgia, 30907, United States

    MARTINEZ, GA 30907

    Phone: (706) 863-7155

    Fax: (706) 863-7981

    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 30907)

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Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1003920901 for Unknown Individual.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Martinez, Georgia?
For routing, start with Martinez, Georgia for Unknown Individual, then verify phone and hours locally.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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