Unknown Individual – Emergency Medicine Physician, NPI 1053356030

Unknown Individual is a healthcare provider. based in Cedartown, Georgia. specializing in Emergency Medicine Physician. They hold a License No. 41801 (GA). The NPI Number for Unknown Individual is 1053356030

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1053356030
Phone
(770) 748-2500
Address
424 N MAIN ST
Deactivation Date
26 March 2026
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

  • One Door Polk, 424, North Main Street, Cedartown, Polk County, Georgia, 30125, United States

    CEDARTOWN, GA 301252644

    Phone: (770) 748-2500

    Type: Location

  • 123 DUDLEY RD SE

    ROME, GA 301619440

    Phone: (706) 238-9929

    Type: Mailing

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 30125)

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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 1053356030 on file in the registry.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Cedartown?
Public fields place Unknown Individual around Cedartown, Georgia. Always confirm the exact site before visiting.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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