Jonathan Ballard, D.C.
Individual provider Active NPI Chiropractor · Owasso, OK
NPI 1134542285 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1134542285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 4148 (OK)
- Practice address
- 435 E 2ND Ave
Owasso, OK 74055-3208 - Phone
- (918) 272-8054
- Fax
- (918) 274-8044
- NPI assigned
- Jan 27, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Cleveland Chiropractic College - Kansas City, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
8787 N Owasso Expy
Suite M
Owasso, OK 74055-4482
Phone (918) 272-8054
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140321001606 | OK | Practitioner - Chiropractic | 0941431647 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4148 | OK | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4148 | OK | Yes |
Addresses
Primary practice location
435 E 2ND Ave
Owasso, OK 74055-3208
Mailing address
435 E 2ND Ave
Owasso, OK 74055-3208
Phone (918) 272-8054
Other providers in Owasso, OK
- Ania Ayodele
- Elizabeth Trigalet Bader
- Bailey Medical Center, LLC
- Lisa Louise Baker
- Ballard Chiropractic
- Kimanda Ballard
- Baptist Village Retirement Communities of Oklahoma, Inc
- Baptist Village Retirement Communities of Oklahoma, Inc
- Baptist Village Retirement Communities of Oklahoma, Inc.
- Kaley Barger
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.