Active NPI
Joseph Balla, M.D.
- Psychiatry Physician
- Raleigh, NC
National Provider Identifier
1407854730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 38893
- Practice address
- 107 Sunnybrook Rd
Raleigh, NC 27610-1827 - Phone
- (919) 250-1260
- NPI assigned
- Jul 11, 2005
- Last updated
- Jan 31, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 38893 | NC | Primary |
Addresses
Primary practice location
107 Sunnybrook Rd
Raleigh, NC 27610-1827
Mailing address
PO Box 46872
Raleigh, NC 27620-6872
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8912911 | Medicaid | NC |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391126400000",
"number": "1407854730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 46872",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276206872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 SUNNYBROOK RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276101827",
"telephone_number": "919-250-1260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLA",
"first_name": "JOSEPH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-11",
"last_updated": "2014-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "38893",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8912911",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.