Blake William Badillo
Individual provider Active NPI Family Nurse Practitioner · Montgomery, AL
NPI 1538052246 · NPPES record last updated Sep 22, 2025
Key facts
- NPI
- 1538052246
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 3-002374 (AL)
- Practice address
- 488 Saint Lukes Dr
Montgomery, AL 36117-7104 - Phone
- (334) 288-7808
- NPI assigned
- Jun 2, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Center for Pain of Montgomery LLC
Practice addresses (Care Compare)
488 Saint Lukes Dr
Montgomery, AL 36117-7104
Phone (334) 288-7808
Hospital & facility affiliations
- Prattville Baptist Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251106001889 | AL | Practitioner - Nurse Practitioner | 0042700239 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3-002374 | AL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Center for Pain of Montgomery LLC | Current |
Accepting new patients | |
| The Center for Pain of Montgomery LLC | Current |
Accepting new patients |
Locations
1022 1st St N
Ste 305
Alabaster, AL 35007
Phone (205) 620-8676
520 John D Odom Rd
Dothan, AL 36303
Phone (334) 500-3511
855 Downtowner Blvd
Mobile, AL 36609
488 Saint Lukes Dr
Montgomery, AL 36117
Phone (256) 496-2635
2065 E South Blvd
Ste 401
Montgomery, AL 36116
432 Saint Lukes Dr
Montgomery, AL 36117
Phone (334) 239-4498
448 Saint Lukes Dr
Montgomery, AL 36117
2101 Chestnut St
Montgomery, AL 36106
Phone (334) 265-9225
3320 Skyway Dr
Ste 701
Opelika, AL 36801
Phone (334) 826-5577
660 McQueen Smith Rd N
Ste E
Prattville, AL 36066
Phone (334) 288-2808
13285 US Highway 231
Troy, AL 36081
201 Defense Hwy
Ste 205
Annapolis, MD 21401
Interoperability endpoints
- blake.badillo.1@11679.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3-002374 | AL | Yes |
Addresses
Primary practice location
488 Saint Lukes Dr
Montgomery, AL 36117-7104
Mailing address
201 Defense Hwy Ste 205
Annapolis, MD 21401-7096
Other practice location 1
507 Privet Ct
Prattville, AL 36066-0011
Phone (618) 979-2776
Other practice location 2
660 McQueen Smith Rd N Ste E
Prattville, AL 36066-7559
Phone (334) 288-7808
Other practice location 3
3320 Skyway Dr Ste 701
Opelika, AL 36801-7139
Phone (334) 288-7808
NPI Registry JSON
{
"created_epoch": "1748822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758499200000",
"number": "1538052246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 DEFENSE HWY STE 205",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214017096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "488 SAINT LUKES DR",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361177104",
"telephone_number": "334-288-7808"
}
],
"practiceLocations": [
{
"address_1": "507 Privet Ct",
"address_purpose": "LOCATION",
"city": "Prattville",
"state": "AL",
"postal_code": "360660011",
"country_code": "US",
"telephone_number": "618-979-2776",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "660 McQueen Smith Rd N Ste E",
"address_purpose": "LOCATION",
"city": "Prattville",
"state": "AL",
"postal_code": "360667559",
"country_code": "US",
"telephone_number": "334-288-7808",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3320 Skyway Dr Ste 701",
"address_purpose": "LOCATION",
"city": "Opelika",
"state": "AL",
"postal_code": "368017139",
"country_code": "US",
"telephone_number": "334-288-7808",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BADILLO",
"first_name": "BLAKE",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-06-02",
"last_updated": "2025-09-22",
"certification_date": "2025-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AL",
"license": "3-002374",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
- Jessica C Babcock
- Sheila Shaffer Babcock
- Lisa Bachant
- Back to Health
- Jungha Back
- Kellie Clayton Bagi
- Bernita Lashell Bailey
- Collin Conroy Bailey
- Jace Bailey
- Joseph M Bailey
All providers in Montgomery, AL · Family Nurse Practitioner in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.