Individual provider Active NPI

Jerry O Batley Jr., MD

  • Surgery Physician
  • Warren, NJ
National Provider Identifier
1366496267
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD2015-0624 Issued in NM
Practice address
34 Mountain Blvd Ste 203
Warren, NJ 07059-2640
Phone
(668) 607-2308
Fax
(248) 855-5455
NPI assigned
May 22, 2006
Last updated
Aug 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101231512 VA
Surgery Physician 208600000X MD2015-0624 NM Primary

Addresses

Primary practice location

34 Mountain Blvd Ste 203
Warren, NJ 07059-2640

Mailing address

7125 Orchard Lake Rd
Ste 316
West Bloomfield, MI 48322-3629
Phone (866) 607-2308

Other identifiers 2

IdentifierTypeStateIssuer
007313004MedicaidVA
33883025MedicaidNM

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101231512VAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shore Family Medicine Ass Past Accepting new patients
Fred J Nahas MD PA Surgery Past Accepting new patients
Centra Health Professional Services, LLC Surgery Past Accepting new patients
Pottstown Clinic Company LLC Surgery PastSince Aug 1, 2021 Accepting new patients
Hill & Kittrell, PLLC Surgery PastSince Jul 1, 2000 Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1366496267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7125 ORCHARD LAKE RD",
            "address_2": "STE 316",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223629",
            "telephone_number": "866-607-2308",
            "fax_number": "248-855-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 MOUNTAIN BLVD STE 203",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070592640",
            "telephone_number": "668-607-2308",
            "fax_number": "248-855-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATLEY",
        "first_name": "JERRY",
        "middle_name": "O",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101231512",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "MD2015-0624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007313004",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33883025",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.