Individual provider Active NPI

Paul David Ballek, BS,RRT

  • Registered Respiratory Therapist
  • Sheridan, WY
National Provider Identifier
1124280656
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Respiratory TherapistTaxonomy code 227900000X
License
121 Issued in WY
Practice address
1898 Fort Rd
Sheridan, WY 82801-8320
Phone
(307) 672-3473
Fax
(307) 672-1962
NPI assigned
Jun 26, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Respiratory Therapist 227900000X 121 WY Primary

Addresses

Primary practice location

1898 Fort Rd
Sheridan, WY 82801-8320

Mailing address

1898 Fort Road
Sheridan, WY 82801
Phone (307) 672-3473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
121WYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1124280656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1898 FORT ROAD",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "82801",
            "telephone_number": "307-672-3473",
            "fax_number": "307-672-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1898 FORT RD",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828018320",
            "telephone_number": "307-672-3473",
            "fax_number": "307-672-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLEK",
        "first_name": "PAUL",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "BS,RRT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227900000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered",
            "state": "WY",
            "license": "121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.