Unknown Individual – Family Medicine Physician, NPI 1861555625

Unknown Individual is a healthcare provider. based in Blakely, Georgia. specializing in Family Medicine Physician. They hold a License No. 010546 (GA). The NPI Number for Unknown Individual is 1861555625

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1861555625
Phone
(229) 723-3541
Address
11045 COLUMBIA ST
Deactivation Date
20 March 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

  • Devon and Blakely, 1225, I Street Northwest, Downtown, Ward 2, Washington, District of Columbia, 20005, United States

    BLAKELY, GA 398233447

    Phone: (229) 723-3541

    Fax: (229) 723-6084

    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 39823)

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Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1861555625 uniquely identifies Unknown Individual in U.S. healthcare data.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Blakely, Georgia?
If you are local to Blakely, Georgia, Unknown Individual may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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