Kelly Ballou, P.A.-C

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

PA0004388 Issued in CO

Practice address

60 Main Street
Ste F,G,H Beaver Plaza Condo
Frisco, CO 80443

Phone

(309) 287-1909

NPI assigned

Jul 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Kelly Gaba Former name

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Destination Dermatology LLC

  • Medical Specialty Clinic/Center
  • Frisco, CO
  • NPI 1205368453
  Medicare reassignment Authorized official
• Decatur Emergency Medical Services II S C

  • Emergency Medical Services (Emergency Medicine) Physician
  • Decatur, IL
  • NPI 1699881508
  NPD (past)
• Francis C Lee, MD SC

  • Dermatology Physician
  • Decatur, IL
  • NPI 1669687984

  Procedural Dermatology

  NPD (past)
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782000000000",
    "number": "1366467805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PARK AVE",
            "address_2": "STE 12-B #1178",
            "city": "BRECKENRIDGE",
            "state": "CO",
            "postal_code": "80424",
            "telephone_number": "970-409-4000",
            "fax_number": "855-839-5617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MAIN STREET",
            "address_2": "STE F,G,H BEAVER PLAZA CONDO",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "80443",
            "telephone_number": "309-287-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLOU",
        "first_name": "KELLY",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2026-06-21",
        "certification_date": "2026-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CO",
            "license": "PA0004388",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA0004388",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "GABA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jayme Joann Aragon, RN
• Axis Sports Medicine, LLC
• B. Simone Caruthers PH.D. P.C.
• Backcountry Chiropractic LLC
• W Douglas Bair, MA, LPC, CAC III
• Viviana Janette Baray Perez, RN BSN
• Trevor William Baringer
• Kaity Barker-Grasser, FNP-BC
• Lewis Brian Barnett, D.O.
• Stephanie Barnett, DMD

• Procedural Dermatology Physician in Frisco, CO
• Providers in Frisco, CO by specialty
• Procedural Dermatology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.