Individual provider Active NPI

Dannica L Ballard, DO

  • Family Medicine Physician
  • Boise, ID
National Provider Identifier
1447946108
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MRO-2242 Issued in ID
Practice address
777 N Raymond St
Boise, ID 83704-9251
Phone
(208) 514-2500
Fax
(208) 375-2217
NPI assigned
Apr 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MRO-2242 ID Primary

Addresses

Primary practice location

777 N Raymond St
Boise, ID 83704-9251

Mailing address

777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500

Other practice location 1

315 E Elm St # 200
Caldwell, ID 83605-4857
Phone (208) 514-2528

Other names 1

  • Dannica L Thornton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20230525002781 ID Order and Referring Only - Family PracticePractitioner - Family Practice 2365808839

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: dballard598659@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1447946108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N RAYMOND ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049251",
            "telephone_number": "208-514-2500",
            "fax_number": "208-375-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 N RAYMOND ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049251",
            "telephone_number": "208-514-2500",
            "fax_number": "208-375-2217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 E Elm St # 200",
            "address_purpose": "LOCATION",
            "city": "Caldwell",
            "state": "ID",
            "postal_code": "836054857",
            "country_code": "US",
            "telephone_number": "208-514-2528",
            "fax_number": "208-375-2217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "DANNICA",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-14",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "MRO-2242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANNICA",
            "last_name": "THORNTON",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.