Unknown Individual – Nephrology Physician, NPI 1073509105

Unknown Individual is a healthcare provider. based in Valdosta, Georgia. specializing in Nephrology Physician. They hold a License No. 018237 (GA). The NPI Number for Unknown Individual is 1073509105

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1073509105
Phone
(229) 247-1414
Address
3564B NORTHCROSSING CIR
Deactivation Date
1 January 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

Provider Addresses for Unknown Individual

  • 3564B NORTHCROSSING CIR

    VALDOSTA, GA 316021067

    Phone: (229) 247-1414

    Fax: (229) 247-1978

    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 31602)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1073509105.
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.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Nephrology Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Georgia?
You will see Valdosta, Georgia on file for Unknown Individual alongside any extra practice locations.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1073509105. Always confirm identity and privileges with the practice and licensing boards.

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