Unknown Individual – Medical Physician Assistant, NPI 1417205345

Unknown Individual is a healthcare provider. based in Milledgeville, Georgia. specializing in Medical Physician Assistant. They hold a License No. 2136 (GA). The NPI Number for Unknown Individual is 1417205345

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1417205345
Phone
(478) 795-0392
Address
2249 VINSON HWY SE
Deactivation Date
27 September 2023
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

Provider Addresses for Unknown Individual

  • 2249 VINSON HWY SE

    MILLEDGEVILLE, GA 310614807

    Phone: (478) 795-0392

    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)

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 31061)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1417205345 when you need to reference Unknown Individual in forms, claims, or directories.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Milledgeville, Georgia for Unknown Individual; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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