Individual provider Active NPI

Jeanne Broussard Ballinger, P.T.

  • Neurology Physical Therapist
  • Austin, TX
National Provider Identifier
1033357017
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology Physical TherapistTaxonomy code 2251N0400X
License
1111870 Issued in TX
Practice address
5555 N Lamar Blvd
Ste L 103
Austin, TX 78751-1073
Phone
(512) 200-2332
Fax
(512) 852-4557
NPI assigned
Jan 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physical Therapist 2251N0400X 1111870 TX Primary

Addresses

Primary practice location

5555 N Lamar Blvd
Ste L 103
Austin, TX 78751-1073

Mailing address

5555 N Lamar Blvd
Ste L 103
Austin, TX 78751-1073
Phone (512) 200-2332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1111870TXMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1033357017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 N LAMAR BLVD",
            "address_2": "STE L 103",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787511073",
            "telephone_number": "512-200-2332",
            "fax_number": "512-852-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 N LAMAR BLVD",
            "address_2": "STE L 103",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787511073",
            "telephone_number": "512-200-2332",
            "fax_number": "512-852-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLINGER",
        "first_name": "JEANNE",
        "middle_name": "BROUSSARD",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-28",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "TX",
            "license": "1111870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.