Demetrious Blackmon (NPI# 1578592994, PAC ID# 6103851225) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEPHROLOGY.
| Nation Provider ID (NPI) | 1578592994 |
| PAC ID by PECOS | 6103851225 |
| Professional Enrollment ID | I20080520000248 |
| Full Name | Demetrious Blackmon |
| Organization Legal Name | SOUTHERN CRESCENT NEPHROLOGY PC |
| Address |
250 Village Ctr Pkwy Suite 100 Stockbridge GA 30281-9104 |
| Phone Number | 6782890508 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE |
| Graduation Year | 2002 |
| Primary Specialty | NEPHROLOGY |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 2466449269 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110191 | PIEDMONT HENRY HOSPITAL |
| 110215 | PIEDMONT FAYETTE HOSPITAL |
| 110165 | SOUTHERN REGIONAL MEDICAL CENTER |
| 110031 | WELLSTAR SPALDING REGIONAL HOSPITAL |
| 110161 | NORTHSIDE HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 | 6782890508 | SOUTHERN CRESCENT NEPHROLOGY PC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_EP_1 | e-Prescribing | 45% | |
| ACI_EC_TRANS_EP_1 | e-Prescribing | 45% | |
| ACI_EC_TRANS_MR_1 | Medication Reconciliation | 98% | |
| ACI_EC_TRANS_MR_1 | Medication Reconciliation | 98% | |
| ACI_EC_TRANS_PEA_1 | Provide Patient Access | 66% | |
| ACI_EC_TRANS_PEA_1 | Provide Patient Access | 66% | |
| ACI_EC_TRANS_PEA_2 | View, Download, or Transmit (VDT) | 5% | |
| ACI_EC_TRANS_PEA_2 | View, Download, or Transmit (VDT) | 5% | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| ACI_EC_TRANS_SM_1 | Secure Messaging | 31% | |
| ACI_EC_TRANS_SM_1 | Secure Messaging | 31% | |
| MIPS_EC_047_overall | Care Plan | 77% | |
| MIPS_EC_047_overall | Care Plan | 77% | |
| MIPS_EC_076_overall | Prevention of Central Venous Catheter (CVC) - Related Bloodstream Infections | 100% | |
| MIPS_EC_076_overall | Prevention of Central Venous Catheter (CVC) - Related Bloodstream Infections | 100% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% | |
| MIPS_EC_145_overall | Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy | 100% | |
| MIPS_EC_145_overall | Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy | 100% |
| Organization Legal Name | SOUTHERN CRESCENT NEPHROLOGY PC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ewalola Ayo Ijaduola | Internal Medicine | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Srikar Kumar | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Latoya R Williams | Nurse Practitioner | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Felice Rogers | Nurse Practitioner | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Muhammed Rahman | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Sanjay Sharma | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Janice Latrice Weatherspoon | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Uma Kumar | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Street Address |
250 VILLAGE CTR PKWY SUITE 100 |
| City | STOCKBRIDGE |
| State | GA |
| Zip | 30281-9104 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ewalola Ayo Ijaduola | Internal Medicine | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Srikar Kumar | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Latoya R Williams | Nurse Practitioner | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Felice Rogers | Nurse Practitioner | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Muhammed Rahman | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Sanjay Sharma | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Janice Latrice Weatherspoon | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Uma Kumar | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Asad M Naqvi | Psychiatry | 135 Eagle Walk, Suite 150, Stockbridge, GA 30281 | |
| Earnest Darren Moore | Certified Registered Nurse Anesthetist (crna) | Anesthesia Solutions of Georgia LLC | 165 N Park Trail, Suite 100, Stockbridge, GA 30281 |
| Whatley B Fenlon | Psychologist, Clinical | 120 Martin Luther King Sr Heritage Trail, Suite 109, Stockbridge, GA 30281 | |
| German M Reyes | General Surgery | Gleneagles Surgery PC | 1215 Eagles Landing, Parkway Suite 105, Stockbridge, GA 30281 |
| Amanda L Hess | Chiropractic | 5430 N Henry Blvd, Suite 100, Stockbridge, GA 30281-3220 | |
| Richard D Buchanan | Chiropractic | 5124 N Henry Blvd, Stockbridge, GA 30281-3232 | |
| Porcia D Ewing | Chiropractic | 5459 N Henry Blvd, Suite C, Stockbridge, GA 30281-3265 | |
| Jeremy A Hess | Chiropractic | 5430 N Henry Blvd, Suite 100, Stockbridge, GA 30281-3270 | |
| Durie D Humber | Chiropractic | 165 Burke St, Suite 105, Stockbridge, GA 30281-3464 | |
| Carrie A Oberster | Chiropractic | 5008 N Henry Blvd, Stockbridge, GA 30281-3561 | |
| Find all physicians in zip 30281 | |||
| City | STOCKBRIDGE |
| Zip Code | 30281 |
| Specialty | NEPHROLOGY |
| City + Specialty | STOCKBRIDGE + NEPHROLOGY |
Please comment or provide details below to improve the information on Demetrious Blackmon.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.