Susan Wanda Balke, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

N6963 Issued in AR

Practice address

171 Cherry St
Marianna, AR 72360-1938

Phone

(870) 295-6205

NPI assigned

Sep 18, 2005

Last updated

Sep 7, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

R Franklin University of Med & Sci/Chicago Medical School, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Forrest City Medical Center Hospital, Forrest City, AR, CCN 040019
• Crestpark Marianna, L L C Nursing home, Marianna, AR, CCN 045449

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Crestpark Marianna, LLC

  • Skilled Nursing Facility
  • Marianna, AR
  • NPI 1659526762
  NPD (past)
• Evergreene Pproperties of North Carolina,LLC

  dba Crestpark of Marianna

  • Skilled Nursing Facility
  • Marianna, AR
  • NPI 1487663449
  NPD (past)

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

• Crestpark Marianna, LLC

  • Skilled Nursing Facility
  • Marianna, AR
  • NPI 1659526762

  Nursing home

  Care Compare affiliation
• Forrest City Arkansas Hospital Company LLC

  dba Forrest City Medical Center

  • General Acute Care Hospital
  • Forrest City, AR
  • NPI 1811912009
  Care Compare affiliation

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

{
    "created_epoch": "1127001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1124013925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 CHERRY ST",
            "city": "MARIANNA",
            "state": "AR",
            "postal_code": "723601938",
            "telephone_number": "870-295-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 CHERRY ST",
            "city": "MARIANNA",
            "state": "AR",
            "postal_code": "723601938",
            "telephone_number": "870-295-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALKE",
        "first_name": "SUSAN",
        "middle_name": "WANDA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-18",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "N6963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111863003",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa M Anderson
• Montiquita Arnold, CASE MANAGER
• Amanda Atchley
• Thomas O Bailey, MD
• Shakendria Baker
• Leslie Denise Barger
• Hayden Barnes
• Jolene Marie Billingsley, PT
• Requisha Denee Brooks, CNA
• Frances Brown, CASE MANAGER

• Family Medicine Physician in Marianna, AR
• Providers in Marianna, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; 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.