Individual provider Active NPI

Ivette Ballara, R.N.

  • Plastic Surgery Registered Nurse
  • Alpharetta, GA
National Provider Identifier
1497373161
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery Registered NurseTaxonomy code 163WS0121X
License
RN183718 Issued in GA
Practice address
3400 Old Milton Pkwy Ste 330
Alpharetta, GA 30005-3707
Phone
(770) 667-3090
Fax
(678) 867-0929
NPI assigned
Jul 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Registered Nurse 163WS0121X RN183718 GA Primary

Addresses

Primary practice location

3400 Old Milton Pkwy Ste 330
Alpharetta, GA 30005-3707

Mailing address

140 Beechwood TRL
Roswell, GA 30075-2309
Phone (404) 272-2224

Other practice location 1

5673 Peachtree Dunwoody Rd Ste 100
Atlanta, GA 30342-1774
Phone (404) 257-9888

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN183718GAMDPlastic Surgery Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Plastic Surgery Centre of Atlanta, P.C. Past Accepting new patients
Mark E. Crispin, M.D., P.C. PastSince Jun 12, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1497373161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BEECHWOOD TRL",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752309",
            "telephone_number": "404-272-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 OLD MILTON PKWY STE 330",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053707",
            "telephone_number": "770-667-3090",
            "fax_number": "678-867-0929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5673 Peachtree Dunwoody Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421774",
            "country_code": "US",
            "telephone_number": "404-257-9888",
            "fax_number": "404-257-1568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALLARA",
        "first_name": "IVETTE",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0121X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Plastic Surgery",
            "state": "GA",
            "license": "RN183718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.