Walter Daniel Ballard II, CERTIFIED PEDORTHIST
Individual provider Active NPI Specialist · Greer, SC
NPI 1194776294 · NPPES record last updated Nov 16, 2007
Key facts
- NPI
- 1194776294
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 37 (SC)
- Practice address
- 24 Parkway Commons Way
Greer, SC 29650-5213 - Phone
- (864) 848-3300
- Fax
- (864) 848-2100
- NPI assigned
- May 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upstate Pedorthic Services Inc. | Current |
Accepting new patients |
Locations
24 Parkway Commons Way
Greer, SC 29650
Phone (864) 848-3300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 37 | SC | Yes |
Addresses
Primary practice location
24 Parkway Commons Way
Greer, SC 29650-5213
Mailing address
24 Parkway Commons Way
Greer, SC 29650-5213
Phone (864) 848-3300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DE1002 | Medicaid | SC | |
| 7702097 | Medicaid | NC |
Other providers in Greer, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.