Kaylen Manning Ballenger, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

256185 Issued in AZ

Practice address

6116 E Arbor Ave Ste 112
Mesa, AZ 85206-6103

Phone

(480) 641-5400

NPI assigned

Apr 3, 2021

Sex

Female

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

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1617408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1336728823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6116 E ARBOR AVE STE 112",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852066103",
            "telephone_number": "480-641-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6116 E ARBOR AVE STE 112",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852066103",
            "telephone_number": "480-641-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2334 E Rawhide St",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852962732",
            "country_code": "US",
            "telephone_number": "480-370-2810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALLENGER",
        "first_name": "KAYLEN",
        "middle_name": "MANNING",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-03",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "256185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas King Baldwin, D.O.
• Lynnette Fae Balentine, NMD
• Aisha Bales, CRNA
• Daniel Ballard, PA
• Karen Kay Ballard, NP
• Kyla Ballesteros, PA-C
• Shelley Poyner Baltodano, AU.D.
• Jeffrey Richard Banas, DC
• Vinay Bandla, M.D
• Sunitha Bandlamuri, MD

• All providers in Mesa, AZ
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.