Active NPI
John S Ballard, MD
- Urology Physician
- San Angelo, TX
National Provider Identifier
1467412064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- D5907
- Practice address
- 3605 Executive Dr
San Angelo, TX 76904-6884 - Phone
- (325) 224-5950
- NPI assigned
- Mar 27, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | D5907 | TX | Primary |
Addresses
Primary practice location
3605 Executive Dr
San Angelo, TX 76904-6884
Mailing address
3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 949-9555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 821792 | Other | TX | BLUE CROSS |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D5907 | TX | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1467412064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3555 KNICKERBOCKER RD",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769047610",
"telephone_number": "325-949-9555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3605 EXECUTIVE DR",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769046884",
"telephone_number": "325-224-5950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLARD",
"first_name": "JOHN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-27",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "TX",
"license": "D5907",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "821792",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Angelo, TX
- Mary Jane Bajaj, MA, LPC, LSOTP, BHSV
- Brad Richard Baker, MD
- William Ed Balderas, DDS
- Sherry Meehan Bales, PT, DPT, FAAOMPT
- Anna Ball
- Ballinger Memorial Hospital District (Park Plaza Nursing and Rehabilitation Center)
- Ballinger Memorial Hospital District (Cedar Manor Nursing and Rehabilitation Center)
- Lindy K. Bankes, MD
- Robin Claire Bankey, PHARM.D.
- Nida Banthupong
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.