DR. SUMPTER DUDLEY BLACKMON (M.D.) – Family Medicine Physician, NPI 1972506194

DR. SUMPTER DUDLEY BLACKMON (M.D.) is a healthcare provider. based in Camden, Alabama. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. 5754 (AL). The NPI Number for DR. SUMPTER DUDLEY BLACKMON (M.D.) is 1972506194

Main info

Male
57 Years Of Experience
Accepts Medicare Assignment
Name
DR. SUMPTER DUDLEY BLACKMON (M.D.)
NPI
1972506194
Phone
(334) 682-4128
Address
PO BOX 699
Enumeration Date
23 May 2005
Deactivation Date
15 March 2006
Reactivation Date
31 March 2006
Last Update Date
15 September 2015

Doctor Profile

Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Secondary Phone
2059262992
Graduation Year
1969 (57 years ago)
PAC ID
2365442258
Group Practice PAC ID
1355597923
Professional Enrollment ID
I20061227000021
Address ID
AL350422935CE195XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:21State licenses:1Digital endpointsOther names

1,754 FAMILY PRACTICE in AL

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Provider Addresses for DR. SUMPTER DUDLEY BLACKMON (M.D.)

  • 699, Hope Road, Camden, Knox County, Maine, 04843, United States of America

    CAMDEN, AL 367260699

    Phone: (334) 682-4128

    Fax: (334) 682-9151

    Type: Mailing

  • Whiskey Run Road, Camden, Wilcox County, Alabama, 36726, United States of America

    CAMDEN, AL 367262303

    Phone: (334) 682-4128

    Fax: (334) 682-9151

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-12-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20061227000021IFamily PracticeALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
81002Urinalysis, manual test2116$0
87811Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)1816$0
View full utilization report →

Insurance plans in this area (ZIP 36726)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355597923View full group profile
NameSpecialtyState
Nurse PractitionerAL
Family PracticeAL
Nurse PractitionerAL
Family PracticeAL
Family PracticeAL
Physical Therapist In Private PracticeAL
Nurse PractitionerAL
Nurse PractitionerAL
Nurse PractitionerAL
-AL

Reviews

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Frequently asked questions

What is the registry number for DR. SUMPTER DUDLEY BLACKMON (M.D.)?
The registry entry for DR. SUMPTER DUDLEY BLACKMON (M.D.) shows NPI 1972506194.
Does the public listing show DR. SUMPTER DUDLEY BLACKMON (M.D.) as active?
DR. SUMPTER DUDLEY BLACKMON (M.D.)'s NPI record reflects an active status in NPPES.
How should patients interpret DR. SUMPTER DUDLEY BLACKMON (M.D.)'s specialty?
The extract shows Family Medicine Physician for DR. SUMPTER DUDLEY BLACKMON (M.D.). Clinical services aligned with this taxonomy classification.
Which community is linked to DR. SUMPTER DUDLEY BLACKMON (M.D.)?
DR. SUMPTER DUDLEY BLACKMON (M.D.) shows a connection to Camden, Alabama in registry-derived data.
Who maintains DR. SUMPTER DUDLEY BLACKMON (M.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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