Active NPI
Jedidiah Amos Ballard, DO
- Emergency Medicine Physician
- Augusta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- DO-05225
- Practice address
- 1120 15TH St
Augusta, GA 30912-0004 - Phone
- (706) 724-6100
- NPI assigned
- Jun 25, 2010
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 19065 | MT | |
| Emergency Medicine Physician | 207P00000X | DO-05225 | IA | Primary |
| Emergency Medicine Physician | 207P00000X | 074216 | GA |
Addresses
Primary practice location
1120 15TH St
Augusta, GA 30912-0004
Mailing address
1499 Walton Way
Suite 1400
Augusta, GA 30901-2603
Phone (706) 724-6100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA, IA, VI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1838 | NE | MD | Chiropractor |
| 074216 | GA | MD | Emergency Medicine Physician |
| 19065 | MT | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Governor Juan F. Luis Hospital & Medical Center | Current | Accepting new patients | |
| Au Medical Associates Inc | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Au Medical Associates Inc | Current | Accepting new patients | |
| Alegent Creighton Clinic | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Alegent Creighton Clinic | Current | Accepting new patients | |
| Au Medical Associates Emergency Medicine Billing Services, LLC | Emergency Medicine | Current | Accepting new patients |
| New Century Physicians of Iowa PC | Emergency Medicine | Current | Accepting new patients |
| Governor Juan F. Luis Hospital & Medical Center | Current | Accepting new patients |
Locations
1120 15th St
Augusta, GA 30912
Phone (706) 721-3873
1499 Walton Way
Ste 1400
Augusta, GA 30901
Phone (706) 721-4951
1120 15th St
Bldg O107
Augusta, GA 30912
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
610 Sparta Rd
Sandersville, GA 31082
Phone (478) 240-2000
800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660
800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000
2771 Solution Ctr
Chicago, IL 60677
7500 Mercy Rd
Omaha, NE 68124
Phone (402) 398-5880
16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500
4007 Estate Diamond Ruby
St Croix, VI 00820
Phone (340) 772-7423
Organizations & group practices 11
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Augusta, GA
- NPI 1982089777
-
- Multi-Specialty Clinic/Center
- Augusta, GA
- NPI 1841230620
-
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Family Medicine Physician
- Council Bluffs, IA
- NPI 1598811069
-
- General Acute Care Hospital
- Christiansted, St. Croix, VI
- NPI 1972503647
-
- Emergency Medicine Physician
- Ottumwa, IA
- NPI 1477017663
-
- Durable Medical Equipment & Medical Supplies
- Augusta, GA
- NPI 1114574126
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
-
- Family Medicine Physician
- Omaha, NE
- NPI 1548287907
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- St Croix, VI
- NPI 1740238534
-
- Emergency Medicine Physician
- Council Bluffs, IA
- NPI 1548269301
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682899200000",
"number": "1023329976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1499 WALTON WAY",
"address_2": "SUITE 1400",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309012603",
"telephone_number": "706-724-6100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 15TH ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120004",
"telephone_number": "706-724-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLARD",
"first_name": "JEDIDIAH",
"middle_name": "AMOS",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-25",
"last_updated": "2023-05-01",
"certification_date": "2023-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MT",
"license": "19065",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IA",
"license": "DO-05225",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "GA",
"license": "074216",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.