NPIMap

Individual provider Active NPI

Jillian Marie Blalock, DO

  • Emergency Medicine Physician
  • Marietta, GA
National Provider Identifier
1003377466
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
91161 Issued in GA
Practice address
677 Church St NE
Marietta, GA 30060-1101
Phone
(770) 793-5000
NPI assigned
Mar 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 91161 GA Primary

Addresses

Primary practice location

677 Church St NE
Marietta, GA 30060-1101

Mailing address

677 Church St NE
Marietta, GA 30060-1101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220421001514 GA Practitioner - Emergency Medicine 7315276912 Reassigns benefits to 7 organizations
I20221230001285 NC Practitioner - Emergency Medicine 7315276912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
West Virginia School of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gordon Emergency Physicians, LLCGroup PAC ID 6406149400, 22 clinicians
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians
Allatoona Emergency Group PCGroup PAC ID 2567847684, 26 clinicians

Practice addresses (Care Compare)

1035 Red Bud Rd NE
Calhoun, GA 30701-6010
Phone (706) 629-2895

3980 Jiles Rd NW
Kennesaw, GA 30144-1109
Phone (678) 504-0100

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-2129
Phone (770) 382-1530

Hospital & facility affiliations

  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Piedmont Cartersville Medical Center Hospital, Cartersville, GA, CCN 110030
  • Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198
  • Northeast Georgia Medical Center Lumpkin Hospital, Dahlonega, GA, CCN 110237
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as group
Quality
83.37
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
99.35 of 100Reported as group
Quality
92.65
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Group of Columbus, LLC Emergency Medicine CurrentSince Mar 11, 2022 Accepting new patients
Gordon Emergency Physicians, LLC Emergency Medicine CurrentSince Feb 2, 2020 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Heritage Physician Services, LLC Emergency Medicine CurrentSince Mar 11, 2022 Accepting new patients
Houston County Emergency Group, LLC Emergency Medicine Current Accepting new patients
Georgia Emergency Department Services, P.C. Emergency Medicine CurrentSince Jan 6, 2025 Accepting new patients
Angelfish Emergency Physicians, LLC Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Sep 15, 2024 Accepting new patients
Murphy Emergency Physicians, PLLC Emergency Medicine CurrentSince Nov 15, 2022 Accepting new patients
Gordon Emergency Physicians, LLC Emergency Medicine CurrentSince Mar 11, 2022 Accepting new patients
Houston County Emergency Group, LLC Emergency Medicine CurrentSince Mar 11, 2022 Accepting new patients

Locations

1035 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 602-7800

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (404) 554-2196

100 Frist Ct
Columbus, GA 31909
Phone (706) 494-2100

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1003377466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 CHURCH ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 CHURCH ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601101",
            "telephone_number": "770-793-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLALOCK",
        "first_name": "JILLIAN",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "91161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.