Unknown Individual – Speech-Language Pathologist, NPI 1033625355

Unknown Individual is a healthcare provider. based in Ellenwood, Georgia. specializing in Speech-Language Pathologist. They hold a License No. SLP007043 (GA). The NPI Number for Unknown Individual is 1033625355

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1033625355
Phone
Not provided
Address
158 GABION LOOP
Deactivation Date
4 January 2023
Data current as of
20 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

  • 158 GABION LOOP

    ELLENWOOD, GA 302942141

    Phone:

    Type: Mailing

  • Peachtree Dunwoody Road, Atlanta, Fulton County, Georgia, 30326, United States

    ATLANTA, GA 303286773

    Phone: (678) 632-5657

    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.

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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 30294)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1033625355 on file in the registry.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Speech-Language Pathologist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Ellenwood, 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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