Unknown Individual – Obstetrics & Gynecology Physician, NPI 1366496168

Unknown Individual is a healthcare provider. based in Newnan, Georgia. specializing in Obstetrics & Gynecology Physician. They hold a License No. 049262 (GA). The NPI Number for Unknown Individual is 1366496168

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1366496168
Phone
(770) 254-9007
Address
75 TILLINGHAST TRCE
Deactivation Date
21 October 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

  • 75 TILLINGHAST TRCE

    NEWNAN, GA 302656036

    Phone: (770) 254-9007

    Fax: (770) 254-8445

    Type: Mailing

  • Old Atlanta Highway, Newnan, Coweta County, Georgia, 30263, United States

    SUITE A

    NEWNAN, GA 302652173

    Phone: (770) 254-9007

    Fax: (770) 254-8445

    Type: Location

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 $19.

Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.

Last reported payment date: 2023-06-20 • Largest payer in this snapshot: ABBVIE INC. ($19).

Total Amount

$19

General + Research + Ownership

Payments

1

Total payment records

General Amount

$19

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-06-20

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$19
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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.

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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 30265)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1366496168.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Obstetrics & Gynecology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Newnan, Georgia in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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