Jason W Balls, OTR/L
Individual provider Active NPI Occupational Therapist · Blackfoot, ID
NPI 1124448675 · NPPES record last updated Feb 10, 2025
Key facts
- NPI
- 1124448675
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT-1903 (ID)
- Practice address
- 586 W 30 S
Blackfoot, ID 83221-6130 - Phone
- (208) 244-5122
- NPI assigned
- Apr 23, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT-1903 | ID | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Root & Renew Pro-Health Solutions | Occupational Therapist | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT-1903 | ID | Yes |
Addresses
Primary practice location
586 W 30 S
Blackfoot, ID 83221-6130
Mailing address
586 W 30 S
Blackfoot, ID 83221-6130
Phone (208) 244-5122
Other providers in Blackfoot, ID
- Awareness Center for Counseling Inc
- Jennifer Joy Awiah
- Jason Michael Bailey
- Nicole Bair
- Bald 1 Sleep Solutions LLC
- Danielle E Bangerter
- Heather Lynn Barndt
- Barnes Physical Therapy, LLC
- Trevor George Barnes
- Blake Barney
All providers in Blackfoot, ID · Occupational Therapist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.