DR. WYATT KENNY BLAKE MD
NPI 1548263064
Family Medicine in Gray, GA

Q: What is Wyatt Blake's NPI number?

The NPI number for Wyatt Blake is 1548263064. It was assigned to this individual provider in the NPPES registry on May 30, 2005.

Q: What is Wyatt Blake's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Wyatt Blake was last updated on July 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 30, 2005PECOS Enrolled

89.25/100

CMS Quality Rating

1005 BOULDER DR, GRAY, GA 31032(478) 621-2100(478) 744-0481 Get Directions Write a Review

NPPES record last updated: July 17, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 17, 2019, Oct 23, 2018 (2 updates tracked since 2018).

On this page

About Dr. Wyatt Kenny Blake Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. WYATT KENNY BLAKE MD (NPI 1548263064) is an individual family medicine provider in Gray, Georgia, licensed in Georgia (047702) and active in the NPI registry since May 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1548263064

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. WYATT KENNY BLAKECredential: MD

Location Address1005 BOULDER DRGray, GA 31032

Mailing Address1005 Boulder DrGray, GA 31032-6141 · (478) 621-2100 · Fax (478) 744-0481

Phone(478) 621-2100

Fax(478) 744-0481

Sole ProprietorNo

Enumeration DateMay 30, 2005

Last NPPES UpdateJuly 17, 20192 updates tracked since enumeration

✔ NPI 1548263064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in GA · 047702

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1005 BOULDER DR, Gray, GA 31032

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Other Identifiers 4

Medicaid000909114EGA

Other047702GA · Ga License

Other080176614GA · Railroad Medicare

Other843785GA · Bcbs Of Georgia

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Wyatt Kenny Blake Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

1,030 services383 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

329 services321 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

300 services291 patients

Advance care planning, first 30 minutes 99497

56 services56 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

39 services37 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

32 services31 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31032 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

89.25/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

Improvement Activities

Reported Quality Measures

Advance Care Plan

100%756 patients5/55-star benchmark: 100%

Dementia Associated Behavioral and Psychiatric Symptoms Screening and Management

100%367 patients

Dementia: Functional Status Assessment

100%367 patients

Dementia: Safety Concern Screening and Follow-Up for Patients with Dementia

100%360 patients

Falls: Plan of Care

100%500 patients

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

100%386 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 16

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Insertion tray without drainage bag and without catheter (accessories only) A4310

DME-Medical/Surgical Supplies · category DA000N

1 supplier32 claims32 services$6.70 avg. paid by Medicare

Urinary catheter anchoring device, adhesive skin attachment, each A4333

DME-Orthotic Devices · category DF000N

1 supplier21 claims39 services$2.14 avg. paid by Medicare

Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4338

DME-Orthotic Devices · category DF000N

1 supplier31 claims31 services$10.09 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

1 supplier34 claims62 services$7.98 avg. paid by Medicare

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034

Other-Enteral and Parenteral · category OB006N

1 supplier22 claims660 services$3.53 avg. paid by Medicare

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035

Other-Enteral and Parenteral · category OB006N

1 supplier12 claims360 services$4.90 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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