Individual provider Active NPI

Carmelita Dennis Blount

  • Diplomate Laboratory Management Specialist/Technologist
  • Locust Grove, GA
National Provider Identifier
1003720723
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diplomate Laboratory Management Specialist/TechnologistTaxonomy code 246QL0901X
Practice address
9042 Holder Rd
Locust Grove, GA 30248-4608
Phone
(770) 883-9413
NPI assigned
Sep 30, 2026
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diplomate Laboratory Management Specialist/Technologist 246QL0901X Primary

Addresses

Primary practice location

9042 Holder Rd
Locust Grove, GA 30248-4608

Mailing address

9042 Holder Rd
Locust Grove, GA 30248-4608
Phone (770) 883-9413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1790726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1003720723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9042 HOLDER RD",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302484608",
            "telephone_number": "770-883-9413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9042 HOLDER RD",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302484608",
            "telephone_number": "770-883-9413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS BLOUNT",
        "first_name": "CARMELITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-30",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QL0901X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Laboratory Management, Diplomate",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Locust Grove, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.