Jill Ballantine, AGACNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

H098201 Issued in IA

Practice address

250 Mercy Dr
Dubuque, IA 52001-7320

Phone

(563) 584-3226

Fax

(563) 584-3227

NPI assigned

Jan 13, 2016

Last updated

Jan 13, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jill Boehmer Former name

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Associates Clinic P CGroup PAC ID 3870491228, 228 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercyone Dubuque Medical Center Hospital, Dubuque, IA, CCN 160069
• Christus Mother Frances Hospital Sulphur Springs Hospital, Sulphur Springs, TX, CCN 450236
• Mercyone Dubuque Medical Center Inpatient rehabilitation facility, Dubuque, IA, CCN 16T069

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jballantine3925668@direct.trinity-health.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Associates Clinic P C

  • Multi-Specialty Clinic/Center
  • Dubuque, IA
  • NPI 1457300790
  Medicare reassignment Care Compare group NPD
• Mercy Medical Center-Dubuque

  dba MercyOne Dubuque Medical Center

  • General Acute Care Hospital
  • Dubuque, IA
  • NPI 1659348506
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Medical Center-Dubuque

  dba MercyOne Dubuque Medical Center-Rehab Unit

  • Rehabilitation Hospital Unit
  • Dubuque, IA
  • NPI 1386679512

  Inpatient rehabilitation facility

  Care Compare affiliation
• Mercy Medical Center-Dubuque

  dba MercyOne Dubuque Medical Center

  • General Acute Care Hospital
  • Dubuque, IA
  • NPI 1659348506
  Care Compare affiliation
• Christus Hopkins Health Alliance

  dba Christus Mother Frances - Sulphur Springs

  • General Acute Care Hospital
  • Sulphur Springs, TX
  • NPI 1033568621
  Care Compare affiliation

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1073979555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ASSOCIATES DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022201",
            "telephone_number": "563-584-4100",
            "fax_number": "563-584-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MERCY DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520017320",
            "telephone_number": "563-584-3226",
            "fax_number": "563-584-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLANTINE",
        "first_name": "JILL",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IA",
            "license": "H098201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "BOEHMER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Benjamin N Baker, CRNA, DNP
• Mackenzie Mae Baker, LISW
• Sharana Baker
• Genevieve A Balajadia, MA, T-CADC
• Eric Balayti
• Lori M Ballew
• Michael James Banyasz, M.D.
• Robin Banyasz
• Tammy Bardon
• Doris A Barnes, C.R.N.A.

• Gerontology Nurse Practitioner in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Gerontology Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.