Jacob Ryan Ball

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1200 N State St
GNH 3900
Los Angeles, CA 90089-1001

Phone

(213) 923-2689

NPI assigned

Mar 21, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1616284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1164008181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 PAVONIA AVE APT 3408",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073062959",
            "telephone_number": "908-334-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "GNH 3900",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900891001",
            "telephone_number": "213-923-2689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALL",
        "first_name": "JACOB",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-21",
        "last_updated": "2023-10-27",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laura Balkian
• Jovana Balkis, PA-C
• Javier F Ball Sepulveda, PH.D.
• Bronwyn E Ball
• Evelyn Gloria Ball, BA
• John Ball, PHARMACIST (PHARMD)
• Nina Nicole Ball, MS
• Megana Ballal
• Amy Suehiro Ballard
• April Marie Ballard

• Student in an Organized Health Care Education/Training Program in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.