Unknown Individual – Nurse Practitioner, NPI 1114983269

Unknown Individual is a healthcare provider. based in Atlanta, Georgia. specializing in Nurse Practitioner. They hold a License No. ARNP 9179755 (FL). The NPI Number for Unknown Individual is 1114983269

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1114983269
Phone
(239) 274-8200
Address
PO BOX 102222
Deactivation Date
7 June 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

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Provider Addresses for Unknown Individual

  • PO BOX 102222

    ATLANTA, GA 303682222

    Phone: (239) 274-8200

    Type: Mailing

  • Veronica S Shoemaker Blvd, Fort Myers, Lee County, Florida, 33916, United States

    ATTN: CREDENTIALING DEPT

    FORT MYERS, FL 339162216

    Phone: (239) 274-8200

    Type: Mailing

  • 9832, US Highway 441, Leesburg, Lake County, Florida, 34788, United States

    SUITE 101

    LEESBURG, FL 347883984

    Phone: (352) 787-3341

    Fax: (352) 787-7491

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $136.

Total Amount is formed as General ($136) + Research ($0) + Ownership ($0) = $136.

Last reported payment date: 2024-10-23 • Largest payer in this snapshot: Pharmacyclics LLC, an AbbVie Company ($47).

Total Amount

$136

General + Research + Ownership

Payments

6

Total payment records

General Amount

$136

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-23

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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 30368)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1114983269 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.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Nurse Practitioner for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Atlanta, Georgia for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1114983269. Always confirm identity and privileges with the practice and licensing boards.

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