Individual provider Active NPI

James C Blackwell, M.D.

  • Internal Medicine Physician
  • Dalton, GA
National Provider Identifier
1063410694
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17132 Issued in GA
Practice address
1432 Broadrick Dr
Dalton, GA 30720-3009
Phone
(706) 226-8990
Fax
(706) 529-5313
NPI assigned
Jul 8, 2005
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 17132 GA Primary
Hospitalist Physician 208M00000X 017132 GA

Addresses

Primary practice location

1432 Broadrick Dr
Dalton, GA 30720-3009

Mailing address

1432 Broadrick Dr
Dalton, GA 30720-3009
Phone (706) 226-8990

Other practice location 1

1200 Memorial Dr
Dalton, GA 30720-2529
Phone (706) 217-2207

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100216000005 GA Practitioner - Internal Medicine 0143292565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Georgia School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hamilton Medical Center, IncGroup PAC ID 0446151179, 105 clinicians

Practice addresses (Care Compare)

1200 Memorial Dr
Dalton, GA 30720-2529
Phone (706) 272-6000

1432 Broadrick Dr
Dalton, GA 30720-3009
Phone (706) 226-8990

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Physician Group Inc CurrentSince Feb 1, 2015 Accepting new patients
Hamilton Medical Center, Inc. CurrentSince Feb 1, 2015 Accepting new patients
Ecc Hospitalist Services PC Internal Medicine Past Accepting new patients

Locations

1107 Memorial Dr
Ste 300
Dalton, GA 30720
Phone (706) 226-3139

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

1432 Broadrick Dr
Dalton, GA 30720
Phone (706) 226-8990

Organizations & group practices 3

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

Hospital & facility affiliations 3

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1063410694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 BROADRICK DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203009",
            "telephone_number": "706-226-8990",
            "fax_number": "706-529-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 BROADRICK DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203009",
            "telephone_number": "706-226-8990",
            "fax_number": "706-529-5313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Dalton",
            "state": "GA",
            "postal_code": "307202529",
            "country_code": "US",
            "telephone_number": "706-217-2207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "JAMES",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "17132",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "017132",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.