Provider Demographics
NPI:1740583103
Name:DR. JAMILA BATTLE & ASSOCIATES, PA
Entity Type:Organization
Organization Name:DR. JAMILA BATTLE & ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMILA
Authorized Official - Middle Name:RANDOLPH
Authorized Official - Last Name:BATTLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-312-0127
Mailing Address - Street 1:PO BOX 1232
Mailing Address - Street 2:
Mailing Address - City:WAKEFOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587
Mailing Address - Country:US
Mailing Address - Phone:888-312-0127
Mailing Address - Fax:888-312-0127
Practice Address - Street 1:8300 HEALTH PARK
Practice Address - Street 2:SUITE 201
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4730
Practice Address - Country:US
Practice Address - Phone:888-312-0127
Practice Address - Fax:888-312-0127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207QA0401X, 207QS1201X, 251S00000X
207RA0401X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep MedicineGroup - Multi-Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5910881Medicaid
NC5910881Medicaid
NC2023296Medicare PIN
202329613Medicare PIN