Unknown Individual – Pediatrics Physician, NPI 1306820477

Unknown Individual is a healthcare provider. based in Carrollton, Georgia. specializing in Pediatrics Physician. They hold a License No. 025856 (GA). The NPI Number for Unknown Individual is 1306820477

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1306820477
Phone
(770) 832-1103
Address
209 DIXIE ST
Deactivation Date
21 September 2022
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

  • 209, Dixie Street, Carrollton, Carroll County, Georgia, 30117, United States

    CARROLLTON, GA 301173308

    Phone: (770) 832-1103

    Fax: (770) 832-1142

    Type: Mailing

  • 410, Newnan Street, Carrollton, Carroll County, Georgia, 30117, United States

    CARROLLTON, GA 301173111

    Phone: (770) 832-1103

    Fax: (770) 832-1142

    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.

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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 30117)

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Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1306820477; it appears in the national provider directory.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Pediatrics Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Georgia?
You will see Carrollton, Georgia on file for Unknown Individual alongside any extra practice locations.
What if Carrollton, Georgia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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