Unknown Individual – Licensed Practical Nurse, NPI 1114191020

Unknown Individual is a healthcare provider. based in Hephzibah, Georgia. specializing in Licensed Practical Nurse. They hold a License No. 164W00000X (GA). The NPI Number for Unknown Individual is 1114191020

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1114191020
Phone
(706) 796-8211
Address
2425 TRAVIS RD
Deactivation Date
3 April 2025
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

Provider Addresses for Unknown Individual

  • 2425 TRAVIS RD

    2425 TRAVIS ROAD

    HEPHZIBAH, GA 308155909

    Phone: (706) 796-8211

    Type: Mailing

  • 300 BLDG

    FORT GORDON, GA 309055650

    Phone: (706) 787-7228

    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.

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 30815)

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Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1114191020 uniquely identifies Unknown Individual in U.S. healthcare data.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Licensed Practical Nurse. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Hephzibah, Georgia in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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