Unknown Individual – Sports Medicine (Family Medicine) Physician, NPI 1083690580

Unknown Individual is a healthcare provider. based in Fort stewart, Georgia. specializing in Sports Medicine (Family Medicine) Physician. They hold a License No. 0101237931 (VA). The NPI Number for Unknown Individual is 1083690580

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1083690580
Phone
(912) 435-6933
Address
1061 HARMON AVE
Deactivation Date
20 December 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Winn Army Community Hospital, 1061, Harmon Avenue, Bowen, Fort Stewart, Liberty County, Georgia, 31314, United States

    FORT STEWART, GA 313145641

    Phone: (912) 435-6933

    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.

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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 31314)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1083690580?
NPI 1083690580 belongs to Unknown Individual; compare other details if you need extra assurance.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Sports Medicine (Family Medicine) Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Fort Stewart, Georgia.
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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