Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1265417489

Unknown Individual is a healthcare provider. based in Mableton, Georgia. specializing in Certified Registered Nurse Anesthetist. They hold a License No. ARNP1332782 (FL). The NPI Number for Unknown Individual is 1265417489

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1265417489
Phone
(305) 302-2893
Address
4507 SANTEE TRAIL
Deactivation Date
2 October 2024
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

  • 4507, Santee Trail Southwest, Mableton, Cobb County, Georgia, 30126, United States

    MABLETON, GA 30126

    Phone: (305) 302-2893

    Type: Mailing

  • 3232, West Royal Lane, Irving, Dallas County, Texas, 75063, United States

    STAFF CARE

    IRVING, TX 75063

    Phone: (972) 501-6484

    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 30126)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1265417489 is assigned to Unknown Individual under the national enumeration system.
How do I interpret inactive records for Unknown Individual?
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 Certified Registered Nurse Anesthetist for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Mableton, Georgia for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1265417489. Always confirm identity and privileges with the practice and licensing boards.

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