Dwight D Blake, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

51117 Issued in GA

Practice address

4910 Jonesboro Rd
BLDG. 700, Ste. 1
Union City, GA 30291-2085

Phone

(770) 964-7736

Fax

(770) 306-1726

NPI assigned

Jun 9, 2006

Last updated

May 13, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Internal Medicine

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rophe Adult and Pediatric MedicineGroup PAC ID 3476551961, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dwight.blake@rapm.eclinicaldirectplus.com

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.

• Yvonne L. Smith MD PC

  dba Rophe Adult & Pediatric Medicine

  • Pediatrics Physician
  • Union City, GA
  • NPI 1831156306
  Medicare reassignment Care Compare group NPD
• Qcpi-Villagemd, PC

  dba Village Medical

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1558872432

  Internal Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fayette Community Hospital, Inc.

  dba Piedmont Fayette Hospital

  • General Acute Care Hospital
  • Fayetteville, GA
  • NPI 1528027240
  Care Compare affiliation

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273708800000",
    "number": "1811938814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 JONESBORO RD",
            "address_2": "BLDG. 700, STE. 1",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302912085",
            "telephone_number": "770-964-7736",
            "fax_number": "770-306-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 JONESBORO RD",
            "address_2": "BLDG. 700, STE. 1",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302912085",
            "telephone_number": "770-964-7736",
            "fax_number": "770-306-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "DWIGHT",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2010-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "51117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary S Batson, REGISTERED NURSE
• Deborah Ann Bean, RN BSN
• Deshawn D Bellamy-Douglas
• Beatrice Berry
• Jaelyn Shantel Blackwell
• Valencia L Blanks
• Tammara R Blunt, CNA
• Dionne Tehsheen Bravo, FNP-C
• Myra Brown, LMHC, LPC
• Naquavia Brown

• Internal Medicine Physician in Union City, GA
• Providers in Union City, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.