Unknown Individual – Adult Health Nurse Practitioner, NPI 1629062708

Unknown Individual is a healthcare provider. based in Smyrna, Georgia. specializing in Adult Health Nurse Practitioner. They hold a License No. RN038536 (GA). The NPI Number for Unknown Individual is 1629062708

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1629062708
Phone
(770) 436-0910
Address
4475 OAKDALE RD SE
Deactivation Date
9 August 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

Provider Addresses for Unknown Individual

  • Oakdale Road Southeast, Oakdale, Smyrna, Georgia, 30126, United States

    SMYRNA, GA 300806933

    Phone: (770) 436-0910

    Type: Mailing

  • 80 JESSE HILL JR DR SE

    BOX 26238

    ATLANTA, GA 303033031

    Phone: (404) 616-4858

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 10 Open Payments records for all available years, with a total value of $987.

Total Amount is formed as General ($987) + Research ($0) + Ownership ($0) = $987.

Last reported payment date: 2023-05-03 • Largest payer in this snapshot: COLOPLAST CORP ($220).

Total Amount

$987

General + Research + Ownership

Payments

10

Total payment records

General Amount

$987

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-05-03

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 30080)

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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 1629062708 for Unknown Individual, then check state licensing separately.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
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 Smyrna, Georgia in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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