Unknown Individual – Optometrist, NPI 1083757645

Unknown Individual is a healthcare provider. based in Gainesville, Georgia. specializing in Optometrist. They hold a License No. OPT001369 (GA). The NPI Number for Unknown Individual is 1083757645

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1083757645
Phone
(770) 503-7334
Address
400 SHALLOWFORD ROAD
Deactivation Date
22 February 2023
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

  • 400 SHALLOWFORD ROAD

    VISION CENTER

    GAINESVILLE, GA 30504

    Phone: (770) 503-7334

    Fax: (770) 503-7321

    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 30504)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1083757645 if you need a stable reference for Unknown Individual.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What kind of provider is Unknown Individual?
The page reflects Optometrist for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Gainesville, Georgia because that is what the record indicates for Unknown Individual.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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