Individual provider Active NPI

Ralph E. Ballard, R.PH., M.B.A.

  • Pharmacist
  • Minneapolis, MN
National Provider Identifier
1164583688
Registry record updated Nov 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
116707-8 Issued in MN
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

Updated by the provider on Nov 26, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
116707-8OtherMNMN 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

LicenseStateTypeSpecialty
116707-8MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.