Individual provider Active NPI

Michelle Catherine Ballard, NP-C

  • Family Nurse Practitioner
  • St George, UT
National Provider Identifier
1114599289
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7531344-4405 Issued in UT
Practice address
1490 E Foremaster Dr Ste 220
St George, UT 84790-4498
Phone
(435) 879-7610
NPI assigned
Jul 16, 2021
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7531344-4405 UT Primary

Addresses

Primary practice location

1490 E Foremaster Dr Ste 220
St George, UT 84790-4498

Mailing address

PO Box 912042
St George, UT 84791-2042
Phone (435) 215-0230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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

Enrollment IDStateProvider typePAC IDDetails
I20210910001638 UT Practitioner - Nurse Practitioner 1052717378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Spine and Pain Care Specialists LLCGroup PAC ID 6406020049, 42 clinicians

Practice addresses (Care Compare)

25 N 2000
Suite 8
Hurricane, UT 84737-4115
Phone (435) 635-0174

2891 E Mall Dr
Suite 102
St George, UT 84790-2399
Phone (435) 703-2930

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.97 of 100Reported as group
Quality
68.31
Promoting interoperability
86
Improvement activities
40
Cost
73.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7531344-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Nov 1, 2021 Accepting new patients
Southwest Spine and Pain Care Specialists, LLC CurrentSince May 1, 2023 Accepting new patients
Revere Health PC CurrentSince Nov 1, 2021 Accepting new patients
Southwest Spine and Pain Care Specialists, LLC CurrentSince May 1, 2023 Accepting new patients

Locations

1303 N Main St
Cedar City, UT 84721
Phone (435) 586-2229

2311 N Main St
#101
Cedar City, UT 84721

25 N 2000 W
Ste 8
Hurricane, UT 84737
Phone (435) 635-0174

700 W 800 N
Ste 220
Orem, UT 84057
Phone (385) 203-1250

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

1490 E Foremaster Dr
Ste 220
St George, UT 84790
Phone (435) 216-7000

2051 E Red Hills Pkwy
Ste 7
St George, UT 84770
Phone (435) 703-2930

2891 E Mall Dr
Ste 101
St George, UT 84790
Phone (435) 688-1634

2891 E Mall Dr
Ste 102
St George, UT 84790

301 N 200 E
Ste 2A
St George, UT 84770
Phone (435) 628-3651

Networks

  • UT PPO D-SNP
  • UT PPO

Interoperability endpoints

  • Direct secure messaging: michelleballard@ssapcsl-ut.direct.office.nextgen.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1114599289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 912042",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847912042",
            "telephone_number": "435-215-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 E FOREMASTER DR STE 220",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904498",
            "telephone_number": "435-879-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "MICHELLE",
        "middle_name": "CATHERINE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "7531344-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.