Blackpool LLC
Blackpool LLC is a healthcare organization registered as Internal Medicine Physician in Cumming, GA, holding Type 2 (organization) NPI 1124361811 since 2013. The authorized official on file is Venkatappa Rangaraj, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1124361811 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Blackpool LLC |
| Other name | <Unavail> |
| Practice address | 4415 FRONT NINE DR STE 600, Cumming, GA, 30041 |
| Phone | 7707447688 |
| Fax | 7704061058 |
| Enumeration date | 2013-04-01 |
| Last updated in NPPES | 2023-02-14 |
Authorized official
| Name | Venkatappa Rangaraj |
|---|---|
| Title | Owner |
| Phone | 5132183468 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207R00000X | Internal Medicine Physician | Primary | 058633 | GA |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003132617A | Medicaid | GA | — |
Copy-ready billing details
Provider: Blackpool LLC NPI: 1124361811 Taxonomy: 207R00000X (Internal Medicine Physician) Address: 4415 FRONT NINE DR STE 600, Cumming, GA, 30041
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1588690879 | Venkatappa Rangaraj | Individual | Internal Medicine Physician | Cumming, GA |
| 1659020519 | Nirali Patel | Individual | Nurse Practitioner | Cumming, GA |
Verify this record
Cross-check NPI 1124361811 against the authoritative CMS record: view Blackpool LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Blackpool LLC?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2023-02-14.