Louie T Ballis, DC
Individual provider Active NPI Chiropractor · Bossier City, LA
NPI 1013020049 · NPPES record last updated Feb 17, 2009
Key facts
- NPI
- 1013020049
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 768 (LA)
- Practice address
- 2170 Airline Dr
Bossier City, LA 71111 - Phone
- (318) 746-4445
- Fax
- (318) 746-0353
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Western States College of Chiropractic, 1986
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2170 Airline Dr
Bossier City, LA 71111-3106
Phone (318) 746-4445
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031230000625 | LA | Practitioner - Chiropractic | 1355249194 | Practice locations: Bossier City, LA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 768 | LA | MD | Psychologist |
Practice roles (1 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Back Pain Chiropractic | Chiropractor | Past | Accepting new patients |
Networks
- LA PPO C-SNP
- MS PPO D-SNP
- TX HMO
- TX HMO D-SNP
- MS PPO
- MS PPO C-SNP
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 768 | LA | Yes |
Addresses
Primary practice location
2170 Airline Dr
Bossier City, LA 71111
Mailing address
2170 Airline Dr
Bossier City, LA 71111-3106
Phone (318) 746-4445
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2918A | Other | LA | BLUE CROSS BLUE SHIELD |
Other providers in Bossier City, LA
- Luster Baker
- Sarah Grace Baker
- Angela Kay Ball
- Brittney Ball
- Paul Allen Ballard
- Attila Balogh
- Michael A Banda
- Lauren Gernand Banet
- Andrew R Banker
- Charlotte E. Banker
All providers in Bossier City, LA · Chiropractor in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2009. 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.
- 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.