Blackpool LLC
NPI 1124361811 · Internal Medicine Physician · Cumming, GA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Blackpool LLC is a Internal Medicine Physician organization in Cumming, GA (NPI 1124361811).
Provider details
- NPI number
- 1124361811
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Venkatappa Rangaraj, Owner(513) 218-3468
- License
- 058633 (GA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Georgia Medical Clinic
- Doing business as
- Georgia Medical Clinic
Registry dates
- Enumerated
- 2013-04-01
- Last updated
- 2023-02-14
- Certified
- 2023-02-14
Frequently asked questions
- What is Blackpool LLC's NPI number?
- Blackpool LLC's National Provider Identifier (NPI) is 1124361811, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Blackpool LLC?
- Blackpool LLC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Blackpool LLC located?
- Blackpool LLC's practice location on file with NPPES is 4415 Front Nine Dr Ste 600, Cumming, GA 30041-6239.
- What is Blackpool LLC's phone number?
- The practice phone number listed in the NPPES registry for Blackpool LLC is (770) 744-7688.
- Does Blackpool LLC accept Medicare?
- Blackpool LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Blackpool LLC?
- The authorized official listed on Blackpool LLC's NPPES record is Venkatappa Rangaraj, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Blackpool LLC's NPI active?
- Yes — Blackpool LLC's NPI (1124361811) is active in the NPPES registry as of the last update on 2023-02-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.