Unknown Individual – Pediatrics Physician, NPI 1487853636

Unknown Individual is a healthcare provider. based in Valdosta, Georgia. specializing in Pediatrics Physician. They hold a License No. 020398 (GA). The NPI Number for Unknown Individual is 1487853636

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1487853636
Phone
(229) 247-2211
Address
3440 N VALDOSTA RD
Deactivation Date
12 June 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 3440, North Valdosta Road, Northwood, Valdosta, Lowndes County, Georgia, 31602, United States

    VALDOSTA, GA 316021079

    Phone: (229) 247-2211

    Fax: (229) 247-9313

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $18.

Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.

Last reported payment date: 2023-08-03 • Largest payer in this snapshot: NESTLE HEALTHCARE NUTRITION INC. ($18).

Total Amount

$18

General + Research + Ownership

Payments

1

Total payment records

General Amount

$18

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-08-03

Latest reported date

Top Companies

Largest payers in this snapshot

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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 31602)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1487853636 if you need a stable reference for Unknown Individual.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Pediatrics Physician. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Valdosta, Georgia for Unknown Individual based on available NPPES addresses.
What if Valdosta, Georgia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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