Blackpool LLC
NPI 1124361811ActiveOrganization· Internal Medicine· Cumming, GA
Internal Medicine in Cumming, Georgia, registered in NPPES in April 2013. The authorized official on file is Venkatappa Rangaraj, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1124361811 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 1, 2013 |
| Last updated in NPPES | Feb 14, 2023 |
| Certified by provider | Feb 14, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | 058633 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (GA) |
|---|
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