Unknown Individual – Internal Medicine Physician, NPI 1164657649

Unknown Individual is a healthcare provider. based in Colquitt, Georgia. specializing in Internal Medicine Physician. They hold a License No. 16704 (GA). The NPI Number for Unknown Individual is 1164657649

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1164657649
Phone
(229) 758-3935
Address
761 E MAIN ST
Deactivation Date
28 November 2024
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

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Provider Addresses for Unknown Individual

  • 761, East Main Street, Colquitt, Miller County, Georgia, 39837, United States

    COLQUITT, GA 398375107

    Phone: (229) 758-3935

    Fax: (229) 758-3935

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $20.

Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.

Last reported payment date: 2024-04-04 • Largest payer in this snapshot: ABBVIE INC. ($20).

Total Amount

$20

General + Research + Ownership

Payments

1

Total payment records

General Amount

$20

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-04

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$20
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 39837)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1164657649 is assigned to Unknown Individual under the national enumeration system.
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 Internal Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Georgia?
You will see Colquitt, Georgia on file for Unknown Individual alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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