Unknown Individual – Registered Dietitian, NPI 1396967303

Unknown Individual is a healthcare provider. based in Douglasville, Georgia. specializing in Registered Dietitian. They hold a License No. LD002635 (GA). The NPI Number for Unknown Individual is 1396967303

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1396967303
Phone
Not provided
Address
2920 LEATHERLEAF TRL
Deactivation Date
8 June 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

  • 2920 LEATHERLEAF TRL

    DOUGLASVILLE, GA 301358933

    Phone:

    Type: Mailing

  • Tanner Medical Center, 705, Dixie Street, Carrollton, Carroll County, Georgia, 30117, United States

    CARROLLTON, GA 301173818

    Phone: (770) 838-9599

    Fax: (770) 836-9148

    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 30135)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1396967303.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Registered Dietitian. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Douglasville, Georgia in registry-derived data.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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