Jimmy E. Ballard, APRN
Individual provider Active NPI Acute Care Nurse Practitioner · Dansville, NY
NPI 1376843458 · NPPES record last updated Nov 12, 2025
Key facts
- NPI
- 1376843458
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- F431664-01 (NY)
- Practice address
- 45 Maple St
Dansville, NY 14437-9182 - Phone
- (585) 335-5052
- Fax
- (585) 335-5061
- NPI assigned
- Oct 24, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240722003654 | NY | Order and Referring Only - Nurse Practitioner | 3173706900 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F431664-01 | NY | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Casa-Trinity, Inc. | Past |
Accepting new patients | |
| Casa-Trinity, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | F431664-01 | NY | Yes |
Addresses
Primary practice location
45 Maple St
Dansville, NY 14437-9182
Mailing address
45 Maple St
Dansville, NY 14437-9182
Phone (585) 335-5052
Other practice location 1
86 River St
Hornell, NY 14843-2265
Phone (607) 282-5201
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06525277 | Medicaid | NY |
Other providers in Dansville, NY
- Jean Archer
- Arif Qureshi, M.D., P.C.
- Jennifer Lyn Ashley
- Catherine/Kit R Bajus
- Heather Baker
- Meghan Marie Barker
- Sandra J Barner
- Steven Patrick Barone
- Leslie Bauch
- Tracy L Bauer
All providers in Dansville, NY · Acute Care Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.