Ballard Medical Products

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

LN-2003-0038 Issued in UT

Legal business name

BALLARD MEDICAL PRODUCTS

Practice address

12050 Lone Peak Pkwy
Draper, UT 84020-9414

Phone

(801) 572-6800

NPI assigned

Aug 19, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Timothy D Dye

Title

General Manager

Phone

(801) 572-6800

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Ballard Medical Laboratory Services Other name

Locations

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043202518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12050 LONE PEAK PKWY",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840209414",
            "telephone_number": "801-572-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12050 LONE PEAK PKWY",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840209414",
            "telephone_number": "801-572-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALLARD MEDICAL PRODUCTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DYE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "801-572-6800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "UT",
            "license": "LN-2003-0038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2277628",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7494105",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLAN",
            "identifier": "A1960874",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballard Medical Laboratory Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Julie P Balk, NP
• Jeffrey Ball
• Matthew Ball
• Ryan Reed Ball, PHARMD
• Pamela Balla-Dibblee, PT
• Meilee Ballard
• Bailey Banbury
• Ana Corina Bancila, PTA, CKTP
• Jacob Bangerter
• Sarah Barba

• Clinical Medical Laboratory in Draper, UT
• Providers in Draper, UT by specialty
• Clinical Medical Laboratory in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.