Unknown Individual – Adult Health Nurse Practitioner, NPI 1558840496

Unknown Individual is a healthcare provider. based in Fortson, Georgia. specializing in Adult Health Nurse Practitioner. They hold a License No. RN142918 (GA). The NPI Number for Unknown Individual is 1558840496

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1558840496
Phone
(706) 324-2110
Address
3550 OLD RIVER RD
Deactivation Date
28 June 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

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Provider Addresses for Unknown Individual

  • 3550 OLD RIVER RD

    FORTSON, GA 318084254

    Phone: (706) 324-2110

    Type: Mailing

  • Whitesville Road, North Kingston, Columbus, Muscogee County, Georgia, 31904, United States

    COLUMBUS, GA 319043230

    Phone: (706) 507-7707

    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.

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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 31808)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1558840496 for Unknown Individual, then check state licensing separately.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's primary classification?
Adult Health Nurse Practitioner is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Fortson, Georgia in our summary view.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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