Individual provider Active NPI

Daniel J Ballard, MD

  • Emergency Medicine Physician
  • Prescott, AZ
National Provider Identifier
1396795472
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34786 Issued in AZ
Practice address
1003 Willow Creek Rd
Prescott, AZ 86301-1641
Phone
(928) 445-2000
NPI assigned
May 11, 2006
Last updated
Feb 27, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34786 AZ Primary

Addresses

Primary practice location

1003 Willow Creek Rd
Prescott, AZ 86301-1641

Mailing address

4202 E Coolidge St
Phoenix, AZ 85018-4236

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060213000770 AZ Practitioner - Emergency Medicine 8921040957 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34786AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Acute Medical Services 1 PC CurrentSince Oct 14, 2019 Accepting new patients
Emergency Group of Arizona Professional Corporation Emergency Medicine CurrentSince Feb 1, 2013 Accepting new patients
Medical Services of Prescott, Inc. Emergency Medicine CurrentSince Dec 1, 2012 Accepting new patients
Valley Emergency Physicians Inc Emergency Medicine Past Accepting new patients
Emergency Physicians Professional Association LTD Emergency Medicine Past Accepting new patients
Valley Emergency Physicians Inc Emergency Medicine Past Accepting new patients
Emergency Physician Professional Association, LTD. Emergency Medicine Past Accepting new patients

Locations

18701 N 67th Ave
Glendale, AZ 85308
Phone (623) 561-1000

1930 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 532-1000

3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000

1003 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 445-2700

7700 E Florentine Rd
Prescott Vly, AZ 86314
Phone (928) 442-8657

Organizations & group practices 7

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1396795472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4202 E COOLIDGE ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850184236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011641",
            "telephone_number": "928-445-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "34786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.