Individual provider Active NPI

Bruce Battle Jr.

  • Mental Health Counselor
  • Albuquerque, NM
National Provider Identifier
1144664830
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1709 Moon St NE
Albuquerque, NM 87112-3935
Phone
(505) 263-3889
Fax
(505) 271-4957
NPI assigned
Apr 24, 2013
Last updated
Apr 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1709 Moon St NE
Albuquerque, NM 87112-3935

Mailing address

1709 Moon St NE
Albuquerque, NM 87112-3935
Phone (505) 263-3889

Other identifiers 1

IdentifierTypeStateIssuer
850165284MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1144664830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 MOON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871123935",
            "telephone_number": "505-263-3889",
            "fax_number": "505-271-4957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 MOON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871123935",
            "telephone_number": "505-263-3889",
            "fax_number": "505-271-4957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATTLE",
        "first_name": "BRUCE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-24",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "850165284",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.