Individual provider Active NPI

Stephanie Bally, APRN

  • Family Nurse Practitioner
  • Nashville, TN
National Provider Identifier
1356991772
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
78990 Issued in KS
Practice address
926 Main St
Nashville, TN 37206-3614
Phone
(615) 436-9060
Fax
(615) 235-9725
NPI assigned
Sep 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 78990 KS Primary
Family Medicine Physician 207Q00000X 5378990072 KS

Addresses

Primary practice location

926 Main St
Nashville, TN 37206-3614

Mailing address

2002 N Quail Crossing St
Andover, KS 67002-7525

Other identifiers 1

IdentifierTypeStateIssuer
201267470AMedicaidKS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stephanie.bally@237407481626628.direct.elationemr.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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

Enrollment IDStateProvider typePAC IDDetails
I20240322003361 KS Order and Referring Only - Nurse Practitioner 3779918966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5378990072KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carebridge Medical Group Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: stephanie.bally@237407481626628.direct.elationemr.com
  • Direct secure messaging: stephanie.bally@krogerhealth.eclinicaldirectplus.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1356991772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 N QUAIL CROSSING ST",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670027525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 MAIN ST",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372063614",
            "telephone_number": "615-436-9060",
            "fax_number": "615-235-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLY",
        "first_name": "STEPHANIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-17",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "78990",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "5378990072",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201267470A",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephanie.bally@237407481626628.direct.elationemr.com",
            "affiliation": "N",
            "endpointDescription": "CareBridge Medical Group - Telehealth",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EMR",
            "address_1": "926 Main St",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372063614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.