NPI age
19 years
Enumerated 2006-06-30
● Active
Type 1 · Individual
DR. Demetrious J. Blackmon, M.D.
Blackmon is 1 of 18 internal medicine providers in Stockbridge and 1 of 562 in Georgia.
Primary specialty
Internal Medicine
Plus 1 subspecialty
Licensed in
GA, TN
2 states
Status
Active
No deactivations on record
Last NPPES update
2015-03-04
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 562 active internal medicine providers in Georgia.
NPI age
19 years
≈ at median (19 yr)
State licenses
2 states
Top 81% — 18% of peers are multi-state
Subspecialties
1
In the 35% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-06Enumerated in NPPES
2006
2026
Where they practice
Practice location
250 Village Center Pwky, Suite 100
Stockbridge, GA 302819044
Mailing address
250 Village Center Pkwy, Suite 100
Stockbridge, GA 302819104
Specialties
-
Internal Medicine PrimaryAn internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
-
Internal MedicineA 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,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (AL) | 009934159 | |
| 05 (GA) | 662769049A | |
| 01 (TN) | P00254515 | RAILROAD MEDICARE |
| 05 (TN) | 3334458 | |
| 01 (TN) | 4111806 | BCBS OF TENNESSEE |
| 05 (GA) | 662769049F | |
| 05 (TN) | 3334459 | |
| 01 (GA) | 581365705 | CHAMPUS |
| 01 (TN) | 4152444 | BLUE CROSS |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.