Individual provider Active NPI

Michelle Charlotte Ballew, LPN

  • Licensed Practical Nurse
  • Manlius, NY
National Provider Identifier
1437339769
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2590022-1 Issued in NY
Practice address
3248 Oran Delphi Rd
Manlius, NY 13104-8610
Phone
(315) 412-2901
NPI assigned
Nov 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2590022-1 NY Primary

Addresses

Primary practice location

3248 Oran Delphi Rd
Manlius, NY 13104-8610

Mailing address

3248 Oran Delphi Rd
Manlius, NY 13104-8610
Phone (315) 412-2901

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

State licenses

LicenseStateTypeSpecialty
2590022-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1194048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1437339769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3248 ORAN DELPHI RD",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131048610",
            "telephone_number": "315-412-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3248 ORAN DELPHI RD",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131048610",
            "telephone_number": "315-412-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLEW",
        "first_name": "MICHELLE",
        "middle_name": "CHARLOTTE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-03",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "2590022-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manlius, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; 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.