Kathleen Ann Ballentine, PA-C

Individual provider Active NPI Medical Physician Assistant · Portsmouth, NH

NPI 1164517504 · NPPES record last updated Sep 27, 2010

Key facts

NPI
1164517504
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
0543P (NH)
Practice address
333 Borthwick Ave, Suite 301
Knees, Hops, Shoulders
Portsmouth, NH 03801
Phone
(603) 431-5858
Fax
(603) 332-2165
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
HHS exclusion list flag
The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0543P NH Yes

Addresses

Primary practice location

333 Borthwick Ave, Suite 301
Knees, Hops, Shoulders
Portsmouth, NH 03801

Mailing address

PO Box 1182
141 Ten Rod Rd
Rochester, NH 03866-1182
Phone (603) 332-4828

Other providers in Portsmouth, NH

All providers in Portsmouth, NH · Medical Physician Assistant in New Hampshire

Sources for this page

Verify at the official NPI Registry.