Individual provider Active NPI

Jamie Rivkin Blalock, MS, APRN, FNP-C

  • Family Nurse Practitioner
  • Blairsville, GA
National Provider Identifier
1073875902
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN149435 Issued in GA
Practice address
15 Earnest Dr
Blairsville, GA 30512-8627
Phone
(706) 745-8790
NPI assigned
Jun 15, 2012
Last updated
Aug 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN149435 GA Primary

Addresses

Primary practice location

15 Earnest Dr
Blairsville, GA 30512-8627

Mailing address

15 Earnest Dr
Blairsville, GA 30512-8627
Phone (706) 745-8790

Other practice location 1

35 Hospital Road
Suite B
Blairsville, GA 30512
Phone (706) 745-2111

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121011000246 GA Practitioner - Nurse Practitioner 5991954745 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

101 Yorktown Dr
Suite 100
Fayetteville, GA 30214-7663
Phone (770) 460-4285

5934 Hwy 515 E
Blairsville, GA 30512-3272
Phone (706) 970-4599

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN149435GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince Aug 12, 2024 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Aug 12, 2024 Accepting new patients
Union County Hospital Authority Current Accepting new patients
Union County Hospital Authority CurrentSince Nov 26, 2013 Accepting new patients
Union County Hospital Authority CurrentSince Nov 26, 2013 Accepting new patients
Hillcrest Clinic, LLC CurrentSince Sep 3, 2012 Accepting new patients
Wendy L Smith M.D. PC Past Accepting new patients

Locations

15 Earnest Dr
Blairsville, GA 30512
Phone (706) 745-0200

35 Hospital Rd
Blairsville, GA 30512
Phone (706) 439-6812

35 Hospital Rd
Ste B
Blairsville, GA 30512

401 Pat Haralson Dr
Unit 1
Blairsville, GA 30512
Phone (706) 745-8790

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jamie.blalock.1@8042.direct.athenahealth.com

Organizations & group practices 7

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 2

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": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1073875902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 EARNEST DR",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305128627",
            "telephone_number": "706-745-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 EARNEST DR",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305128627",
            "telephone_number": "706-745-8790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Hospital Road",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Blairsville",
            "state": "GA",
            "postal_code": "30512",
            "country_code": "US",
            "telephone_number": "706-745-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLALOCK",
        "first_name": "JAMIE",
        "middle_name": "RIVKIN",
        "credential": "MS, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-15",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN149435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blairsville, GA

Sources for this page

Verify at the official NPI Registry.