Individual provider Active NPI

John Thomas Blasingame III, M.D.

  • Specialist
  • Atlanta, GA
National Provider Identifier
1780659128
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
035379 Issued in GA
Practice address
2045 Peachtree Rd NE
Suite 300
Atlanta, GA 30309-1414
Phone
(404) 352-4440
Fax
(404) 352-4446
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 035379 GA Primary

Addresses

Primary practice location

2045 Peachtree Rd NE
Suite 300
Atlanta, GA 30309-1414

Mailing address

2759 Engle Rd NW
Atlanta, GA 30318-7214
Phone (404) 794-0399

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
I20040819000943 GA Practitioner - Emergency Medicine 0840263539 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coweta Emergency Group LLC CurrentSince Aug 20, 2016 Accepting new patients
The Bortolazzo Group, LLC CurrentSince Feb 15, 2020 Accepting new patients
Angelfish Emergency Physicians, LLC CurrentSince Dec 11, 2014 Accepting new patients
Peachtree Emergency Associates Past Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1780659128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2759 ENGLE RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303187214",
            "telephone_number": "404-794-0399",
            "fax_number": "404-794-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 PEACHTREE RD NE",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091414",
            "telephone_number": "404-352-4440",
            "fax_number": "404-352-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASINGAME",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "035379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.