Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dedra J Blalock

Individual provider Cardiovascular Disease Physician · NPI 1619063153

Dedra J Blalock is a Nurse Practitioner in Atlanta, Georgia. Qualified in 2003, 23 years ago. Practices with The Emory Clinic Inc, a 3,500-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
23
Licensed in
GA
In the registry since
2006
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Practice location Address checks out

550 Peachtree St
Atlanta, GA 30308
Phone: (404) 686-7431
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Cardiovascular Disease Physician (primary) Taxonomy 207RC0000X · Licence APRN-NP089049 (GA)

Record details

NPI number1619063153
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 4, 2006
Last updated in NPPESOctober 20, 2025
Certification dateOctober 20, 2025
Mailing address550 Peachtree St Ne, Atlanta, GA 30308-2212

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice The Emory Clinic Inc — 3500 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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