Organization provider

BLACKPOOL LLC

Internal Medicine Physician Medicare enrolled

BLACKPOOL LLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1124361811, based in Cumming, GA. It is classified under Internal Medicine Physician.

Getting there

The practice address on file is 4415 FRONT NINE DR STE 600, Cumming, GA 30041. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

4415 FRONT NINE DR STE 600, Cumming, GA 30041 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
058633 GA Internal Medicine Physician primary

This provider holds licence 058633 issued in GA. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.

Medicare (PECOS)
Status
Approved
Provider type
Part B Supplier - Clinic/group Practice
PAC ID
2163667643

Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

What Internal Medicine covers

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. NUCC Health Care Provider Taxonomy, code 207R00000X
Allopathic & Osteopathic Physicians Internal Medicine

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.

NPI1124361811 valid check digit
Entity typeOrganization (NPI-2)
Enumeration dateApr 1, 2013
Last updatedFeb 14, 2023
StatusActive
Practice address 4415 FRONT NINE DR STE 600
Cumming, GA 30041
(770) 744-7688
Fax (770) 406-1058
Other identifiers 003132617A (GA)
The last update on file is Feb 14, 2023. Providers are only required to update NPPES when their information changes, so an older date does not necessarily mean the details are wrong — but it is worth a quick call before you travel.

Number check

1124361811 passes the NPI check digit test The final digit 1 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 1 2 4 3 6 1 8 1
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 1 4 4 6 6 2 8 2

Sum = 59 · next multiple of 10 = 60 · check digit = 1 · actual last digit = 1

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1124361811?
NPI 1124361811 is the National Provider Identifier assigned to BLACKPOOL LLC in Cumming, GA. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Internal Medicine Physician cover?
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive…
How do I contact BLACKPOOL LLC?
The phone number on file with NPPES is (770) 744-7688, last updated Feb 14, 2023. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does BLACKPOOL LLC accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1124361811 a valid number?
Yes. 1124361811 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.