Tameka Walker-Blake, M.D.
Individual provider Active NPI Emergency Medicine Physician · Smyrna, GA
NPI 1295960581 · NPPES record last updated Oct 4, 2011
Key facts
- NPI
- 1295960581
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 062448 (GA)
- Practice address
- 3949 S Cobb Dr SE
Smyrna, GA 30080-6342 - Phone
- (770) 438-5222
- NPI assigned
- May 15, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090821000168 | GA | Practitioner - Emergency Medicine | 8325192537 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Theoria Medical | Current |
Accepting new patients | |
| Angelfish Emergency Physicians, LLC | Emergency Medicine | Current |
Accepting new patients |
| Emerginet Henry, LLC | Past | Accepting new patients | |
| Roberta Operator LLC | Past | Accepting new patients | |
| Fort Valley Operator LLC | Past | Accepting new patients | |
| Coliseum Drive Associates LLC | Past | Accepting new patients | |
| Bainbridge Operator LLC | Past | Accepting new patients |
Locations
5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340
7560 Butner Rd
Fairburn, GA 30213
Phone (770) 306-7878
7300 Lester Rd
Union City, GA 30291
Phone (770) 703-2604
41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 062448 | GA | Yes |
Addresses
Primary practice location
3949 S Cobb Dr SE
Smyrna, GA 30080-6342
Mailing address
3949 S Cobb Dr SE
Smyrna, GA 30080-6342
Phone (770) 438-5222
Other providers in Smyrna, GA
- Nobuhiro Wago
- Walgreen Co
- Walgreen Co
- Walgreen Co
- Walgreen Co
- Amber Walker
- Bianca Walker
- Sonya Coutee Wallace
- Kelly L Walsh
- Zachary E Walston
All providers in Smyrna, GA · Emergency Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.