Active NPI
Ralph E. Ballard, R.PH., M.B.A.
- Pharmacist
- Minneapolis, MN
National Provider Identifier
1164583688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 116707-8
- Practice address
- 1313 Penn Ave N
Pharmacy
Minneapolis, MN 55411-3047 - Phone
- (612) 302-4600
- Fax
- (612) 302-4663
- NPI assigned
- Dec 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 116707-8 | MN | Primary |
Addresses
Primary practice location
1313 Penn Ave N
Pharmacy
Minneapolis, MN 55411-3047
Mailing address
1305 Corporate Center Dr
Eagan, MN 55121-1204
Phone (612) 777-5176
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 116707-8 | Other | MN | MN BOARD OF PHARMACY LIC. |
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
- Master of Business Administration, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 116707-8 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prime Therapeutics LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mail Order Pharmacy
- Eagan, MN
- NPI 1669601878
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227657600000",
"number": "1164583688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1305 CORPORATE CENTER DR",
"city": "EAGAN",
"state": "MN",
"postal_code": "551211204",
"telephone_number": "612-777-5176",
"fax_number": "612-777-5141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1313 PENN AVE N",
"address_2": "PHARMACY",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554113047",
"telephone_number": "612-302-4600",
"fax_number": "612-302-4663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLARD",
"first_name": "RALPH",
"middle_name": "E.",
"name_prefix": "Mr.",
"credential": "R.PH., M.B.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2008-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "116707-8",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MN BOARD OF PHARMACY LIC.",
"identifier": "116707-8",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 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.