Provider Demographics
NPI:1528099421
Name:SMOKEY MOUNTAIN HEALTHCARE ASSOC PA
Entity type:Organization
Organization Name:SMOKEY MOUNTAIN HEALTHCARE ASSOC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:BATTLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:823-369-4257
Mailing Address - Street 1:PO BOX 1205
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28744
Mailing Address - Country:US
Mailing Address - Phone:828-369-7257
Mailing Address - Fax:828-349-6603
Practice Address - Street 1:190 RIVERVIEW STREET
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734
Practice Address - Country:US
Practice Address - Phone:828-369-4257
Practice Address - Fax:828-349-6603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26427207Q00000X
NC9500793207Q00000X
NC9600013207Q00000X
NC31283207R00000X
NC100249363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8933654Medicaid
NC8913820Medicaid
NC8912721Medicaid
NC8954660Medicaid
204108BMedicare ID - Type Unspecified
G24068Medicare UPIN
C82302Medicare UPIN
S46457Medicare UPIN
2744582Medicare ID - Type Unspecified
D70673Medicare UPIN
2221753AMedicare ID - Type Unspecified
NC8954660Medicaid
C81457Medicare UPIN
NC8913820Medicaid