Unknown Individual – Psychiatry Physician, NPI 1700974045

Unknown Individual is a healthcare provider. based in Martinez, Georgia. specializing in Psychiatry Physician. They hold a License No. 31019 (GA). The NPI Number for Unknown Individual is 1700974045

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1700974045
Phone
(706) 869-4175
Address
4210 COLUMBIA RD
Deactivation Date
11 October 2024
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

  • Martinez, Wynngate, Columbia County, Georgia, United States

    STE. 5A

    MARTINEZ, GA 309070401

    Phone: (706) 869-4175

    Fax: (706) 869-4179

    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 $39.

Total Amount is formed as General ($39) + Research ($0) + Ownership ($0) = $39.

Last reported payment date: 2024-09-18 • Largest payer in this snapshot: Boston Scientific Corporation ($39).

Total Amount

$39

General + Research + Ownership

Payments

1

Total payment records

General Amount

$39

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-18

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 30907)

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Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1700974045 in the public NPI dataset.
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 specialty?
The listing groups Unknown Individual with Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Martinez, Georgia in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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