Individual provider Active NPI

Julia Esther Balcom, MN,BSN

  • Family Nurse Practitioner
  • Dallas, OR
National Provider Identifier
1194153494
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201391421NP-PP Issued in OR
Practice address
531 SE Clay St
Dallas, OR 97338-2865
Phone
(971) 612-6100
Fax
(971) 612-6101
NPI assigned
Oct 23, 2013
Last updated
Sep 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201391421NP-PP OR Primary

Addresses

Primary practice location

531 SE Clay St
Dallas, OR 97338-2865

Mailing address

PO Box 1517
Pendleton, OR 97801-0410
Phone (877) 708-1119

Other names 1

  • Julia Esther Thomas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140221000392 OR Practitioner - Nurse Practitioner 1557591427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Praxis Health PCGroup PAC ID 8325941446, 174 clinicians

Practice addresses (Care Compare)

929 SW Simpson Ave
Bend, OR 97702-3599
Phone (541) 389-7741

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201391421NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Praxis Health, PC Family CurrentSince Sep 1, 2021 Accepting new patients
Praxis Health, PC CurrentSince Sep 1, 2021 Accepting new patients

Locations

929 SW Simpson Ave
Bend, OR 97702
Phone (541) 848-6642

531 SE Clay St
Dallas, OR 97338
Phone (503) 623-5430

4999 Skyline Rd S
Ste 100
Salem, OR 97306
Phone (503) 364-4005

Interoperability endpoints

  • Direct secure messaging: jbalcom237704@direct.salemhealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1194153494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010410",
            "telephone_number": "877-708-1119",
            "fax_number": "541-278-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 SE CLAY ST",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973382865",
            "telephone_number": "971-612-6100",
            "fax_number": "971-612-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALCOM",
        "first_name": "JULIA",
        "middle_name": "ESTHER",
        "credential": "MN,BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-23",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201391421NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIA",
            "last_name": "THOMAS",
            "middle_name": "ESTHER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, OR

Sources for this page

Verify at the official NPI Registry.