Active NPI
Sumpter Dudley Blackmon, M.D.
- Family Medicine Physician
- Camden, AL
National Provider Identifier
1972506194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5754
- Practice address
- 321 Whiskey Run Rd
Camden, AL 36726-2303 - Phone
- (334) 682-4128
- Fax
- (334) 682-9151
- NPI assigned
- May 23, 2005
- Reactivated
- Mar 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5754 | AL | Primary |
Addresses
Primary practice location
321 Whiskey Run Rd
Camden, AL 36726-2303
Mailing address
PO Box 699
Camden, AL 36726-0699
Phone (334) 682-4128
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000454 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061227000021 | AL | Practitioner - Family Practice | 2365442258 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Alabama School of Medicine, 1969
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cahaba Medical Care Foundation
Practice addresses (Care Compare)
195 Hospital Dr
Centreville, AL 35042-2935
Phone (205) 926-2992
Hospital & facility affiliations
- Alabama Homecare
- J Paul Jones Hospital
- Baptist Medical Center South
- Vaughan Regional Medical Center Parkway Campus
- Monroe County Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5754 | AL | MD | Dentist |
Practice roles (2 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cahaba Medical Care Foundation | Current | Accepting new patients | |
| Cahaba Medical Care Foundation | Current | Accepting new patients |
Locations
321 Whiskey Run Rd
Camden, AL 36726
Phone (334) 682-4128
195 Hospital Dr
Centreville, AL 35042
Phone (205) 225-7455
Networks
- bcbs alabama network 01C0
- bcbs alabama network 01A0
- bcbs alabama network 01H0
- bcbs alabama network 01E0
- bcbs alabama network 01G0
- bcbs alabama network 01B0
Interoperability endpoints
- sumpter.blackmon.1@13125.direct.athenahealth.com
- sumpter.blackmon.1@11347.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Federally Qualified Health Center (FQHC)
- Centreville, AL
- NPI 1316201809
AL
-
- Federally Qualified Health Center (FQHC)
- Centreville, AL
- NPI 1316542624
-
- Federally Qualified Health Center (FQHC)
- Birmingham, AL
- NPI 1881153401
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Camden, AL
- NPI 1659604924
-
- General Acute Care Hospital
- Montgomery, AL
- NPI 1700977105
Hospital
-
- Critical Access Hospital
- Monroeville, AL
- NPI 1457392904
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442275200000",
"number": "1972506194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 699",
"city": "CAMDEN",
"state": "AL",
"postal_code": "367260699",
"telephone_number": "334-682-4128",
"fax_number": "334-682-9151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "321 WHISKEY RUN RD",
"city": "CAMDEN",
"state": "AL",
"postal_code": "367262303",
"telephone_number": "334-682-4128",
"fax_number": "334-682-9151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKMON",
"first_name": "SUMPTER",
"middle_name": "DUDLEY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-23",
"last_updated": "2015-09-15",
"deactivation_date": "2006-03-15",
"reactivation_date": "2006-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AL",
"license": "5754",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000000454",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Camden, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; 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.