Active NPI
Elizabeth Haley Ballard
- Occupational Therapy Assistant
- McMinnville, TN
National Provider Identifier
1457738049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 2443
- Practice address
- 415 Pace St
McMinnville, TN 37110-1246 - Phone
- (931) 668-2011
- NPI assigned
- May 3, 2015
- Last updated
- May 3, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 2443 | TN | Primary |
Addresses
Primary practice location
415 Pace St
McMinnville, TN 37110-1246
Mailing address
107 Murray Estates Dr
Murray, KY 42071-4672
Phone (270) 293-1309
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2443 | Other | TN | STATE LICENSURE NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2443 | TN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430611200000",
"number": "1457738049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 MURRAY ESTATES DR",
"city": "MURRAY",
"state": "KY",
"postal_code": "420714672",
"telephone_number": "270-293-1309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 PACE ST",
"city": "MCMINNVILLE",
"state": "TN",
"postal_code": "371101246",
"telephone_number": "931-668-2011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLARD",
"first_name": "ELIZABETH",
"middle_name": "HALEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-03",
"last_updated": "2015-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TN",
"license": "2443",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSURE NUMBER",
"identifier": "2443",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in McMinnville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.