Rocky Bryan Ballard

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

4009 Eufaula Ave
Muskogee, OK 74403-1132

Phone

(191) 868-2284

NPI assigned

Oct 24, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1194597013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N 15TH ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744013112",
            "telephone_number": "918-537-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 EUFAULA AVE",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744031132",
            "telephone_number": "191-868-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "ROCKY",
        "middle_name": "BRYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Balanced Body Chiropractic LLC
• Jonathan Martin Baldwin, MD
• William Floyd Baldwin Jr.
• Kriston Leeann Balfour Moore
• Mallory Ball, COTA
• Darby Lynn Ballestero, PHARM.D.
• Raffy Ballesteros, P.T.
• Danielle Balletto
• George Robert Ballew, DDS
• Misti Ballew

• Peer Specialist in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.