Kendra Ballesteros, P.T.A.

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

2003029643 Issued in MO

Practice address

11960 Westline Industrial Drive #201
St. Louis, MO 63146-3209

Phone

(314) 890-0480

NPI assigned

Apr 8, 2015

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1386030138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11960 WESTLINE INDUSTRIAL DR STE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11960 WESTLINE INDUSTRIAL DRIVE #201",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631463209",
            "telephone_number": "314-890-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLESTEROS",
        "first_name": "KENDRA",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-08",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MO",
            "license": "2003029643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jodi Ballmann, OT
• Reinis Balmaks, M.D.
• Luqman Baloch, M.D.

• Community Health Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Community Health Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.