Brian J Ballard, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

118T Issued in WY

Practice address

300 N Broadway Ave
Riverton, WY 82501-3545

Phone

(307) 856-9451

Fax

(307) 856-8548

NPI assigned

Aug 18, 2005

Last updated

Oct 7, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Dubois Vision Center

  • Optometrist
  • Dubois, WY
  • NPI 1073505699
  Authorized official Same address or phone
• Riverton Vision Center P.C.

  • Optometrist
  • Riverton, WY
  • NPI 1962494690
  Authorized official Same address or phone

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1114919826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N BROADWAY AVE",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825013545",
            "telephone_number": "307-856-9451",
            "fax_number": "307-856-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N BROADWAY AVE",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825013545",
            "telephone_number": "307-856-9451",
            "fax_number": "307-856-8548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "BRIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WY",
            "license": "118T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE",
            "identifier": "0762340001",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104136300",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allie T Austin
• Paul Alan Axthelm, DDS
• Tiffany L Bader, MS, OTR/L
• Milsom June Baiely
• Michael Donald Baldwin, RPH
• Banner Health Physicians West LLC
• Shanda Barlow
• Heather Barrows
• Wyatt Chester Barrus, PA-C
• Grant A Basko

• Optometrist in Riverton, WY
• Providers in Riverton, WY by specialty
• Optometrist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.