Active NPI
Darrell Ballard
- Community Health Worker
- North Las Vegas, NV
National Provider Identifier
1194118455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 4104 Herblinda LN
North Las Vegas, NV 89032-2707 - Phone
- (702) 351-1416
- NPI assigned
- Mar 11, 2015
- Last updated
- Mar 11, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | NU | Primary |
Addresses
Primary practice location
4104 Herblinda LN
North Las Vegas, NV 89032-2707
Mailing address
4104 Herblinda LN
North Las Vegas, NV 89032-2707
Phone (702) 351-1416
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 172V00000X | Medicaid | NV |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426032000000",
"number": "1194118455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4104 HERBLINDA LN",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890322707",
"telephone_number": "702-351-1416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4104 HERBLINDA LN",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890322707",
"telephone_number": "702-351-1416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLARD",
"first_name": "DARRELL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-03-11",
"last_updated": "2015-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "172V00000X",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.