NPIMap

Individual provider Active NPI

Marie Blaize

  • Hospitalist Physician
  • Carrollton, GA
National Provider Identifier
1275979205
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
076302 Issued in GA
Practice address
705 Dixie St
Carrollton, GA 30117-3818
Phone
(770) 838-8824
Fax
(770) 838-8563
NPI assigned
May 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD61514731 WA
Internal Medicine Physician 207R00000X 076302 GA
Hospitalist Physician 208M00000X 076302 GA Primary

Addresses

Primary practice location

705 Dixie St
Carrollton, GA 30117-3818

Mailing address

119 Ambulance Dr
Suite 202
Carrollton, GA 30117-3857
Phone (770) 838-8824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WA, CA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20160823000826 GA Practitioner - HospitalistPractitioner - Internal Medicine 0941521298 Reassigns benefits to 2 organizations
I20240123005007 WA Practitioner - Internal Medicine 0941521298 Reassigns benefits to 1 organization
I20250422000778 CA Practitioner - Internal Medicine 0941521298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
South Sound Inpatient Physicians PLLCGroup PAC ID 5991618738, 424 clinicians
Inpatient Specialists of California PCGroup PAC ID 3476864448, 373 clinicians
Apogee Medical Group GeorgiaGroup PAC ID 4587676945, 122 clinicians

Practice addresses (Care Compare)

101 N Main St
Coupeville, WA 98239-3413
Phone (360) 678-5151

350 S Oak Ave
Oakdale, CA 95361-3519
Phone (209) 847-3012

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-4000

705 Dixie St
Carrollton, GA 30117-3818
Phone (770) 812-9666

Hospital & facility affiliations

  • Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011
  • Whidbeyhealth Medical Center Hospital, Coupeville, WA, CCN 501339
  • Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015
  • Oak Valley Hospital District Hospital, Oakdale, CA, CCN 050067
  • Tanner Medical Center-East Alabama Hospital, Wedowee, AL, CCN 011306

Merit-based Incentive Payment System (MIPS)

Final score
87.29 of 100Reported as group
Quality
70.79
Improvement activities
40
Cost
81.32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
076302GAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Specialists of California, PC Internal Medicine CurrentSince Mar 12, 2025 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine Current Accepting new patients
South Sound Inpatient Physicians, PLLC Internal Medicine CurrentSince Jan 1, 2024 Accepting new patients
Apogee Medical Group Georgia Internal Medicine CurrentSince Jul 25, 2017 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Jan 1, 2024 Accepting new patients
Utm of Georgia Physicians LLC CurrentSince Jul 3, 2023 Accepting new patients
Mount Lassen Emergency Physicians LLC Past Accepting new patients

Locations

350 S Oak Ave
Oakdale, CA 95361
Phone (209) 847-3011

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

200 Allen Memorial Dr
Bremen, GA 30110
Phone (770) 537-5851

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

400 Battlefield Pkwy
Ft Oglethorpe, GA 30742
Phone (706) 944-9018

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

601 Dallas Hwy
Villa Rica, GA 30180
Phone (770) 456-3000

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1275979205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 AMBULANCE DR",
            "address_2": "SUITE 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173857",
            "telephone_number": "770-838-8824",
            "fax_number": "770-838-8563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 DIXIE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173818",
            "telephone_number": "770-838-8824",
            "fax_number": "770-838-8563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIZE",
        "first_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-16",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61514731",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "076302",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "076302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.