Individual provider Active NPI

Takara Joelle Ballard

  • Home Health Agency
  • Detroit, MI
National Provider Identifier
1417796806
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Practice address
14017 Coyle St
Detroit, MI 48227-2500
Phone
(313) 500-5168
NPI assigned
May 23, 2024
Last updated
May 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

14017 Coyle St
Detroit, MI 48227-2500

Mailing address

14017 Coyle St
Detroit, MI 48227-2500
Phone (313) 500-5168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1417796806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14017 COYLE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482272500",
            "telephone_number": "313-500-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14017 COYLE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482272500",
            "telephone_number": "313-500-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "TAKARA",
        "middle_name": "JOELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.