Unknown Individual – Anesthesiologist Assistant, NPI 1992869317

Unknown Individual is a healthcare provider. based in Marietta, Georgia. specializing in Anesthesiologist Assistant. They hold a License No. 4912 (GA). The NPI Number for Unknown Individual is 1992869317

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1992869317
Phone
(770) 794-0477
Address
677 CHURCH ST NE
Deactivation Date
7 August 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

  • 677, Church Street Northeast, Elizabeth, Marietta, Cobb County, Georgia, 30060, United States

    MARIETTA, GA 300601101

    Phone: (770) 794-0477

    Fax: (770) 794-3108

    Type: Location

  • 300, Amberidge Trail Northwest, Atlanta, Fulton County, Georgia, 30328, United States

    ATLANTA, GA 303282805

    Phone:

    Type: Mailing

  • 1156 WINBORN TRL NW

    KENNESAW, GA 301526983

    Phone:

    Type: Mailing

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 30060)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1992869317?
NPI 1992869317 belongs to Unknown Individual; compare other details if you need extra assurance.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Anesthesiologist Assistant. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Marietta?
Public fields place Unknown Individual around Marietta, Georgia. Always confirm the exact site before visiting.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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