Individual provider Active NPI

Tracie M Battle

  • General Practice Dentistry
  • Huntsville, AL
National Provider Identifier
1417120841
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5312 Issued in AL
Practice address
5045 N Memorial Pkwy
Ste.D
Huntsville, AL 35810-1077
Phone
(256) 859-0902
NPI assigned
Apr 7, 2008
Last updated
Apr 7, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5312 AL Primary

Addresses

Primary practice location

5045 N Memorial Pkwy
Ste.D
Huntsville, AL 35810-1077

Mailing address

PO Box 1777
Normal, AL 35762-1777
Phone (256) 859-0902

Other identifiers 1

IdentifierTypeStateIssuer
009961335MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161021001933 TN Order and Referring Only - Other (Non-Physician) 2961780168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Smile Center of Covington PC Current Accepting new patients
Smile Center of Covington PC Current Accepting new patients
Great Expressions Dental Care General Practice Past Accepting new patients

Organizations & group practices 4

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": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207526400000",
    "number": "1417120841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1777",
            "city": "NORMAL",
            "state": "AL",
            "postal_code": "357621777",
            "telephone_number": "256-859-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5045 N MEMORIAL PKWY",
            "address_2": "STE.D",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358101077",
            "telephone_number": "256-859-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATTLE",
        "first_name": "TRACIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-07",
        "last_updated": "2008-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009961335",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.