Megan Myers Balliet, NP-C

Key facts

NPI

1578841276

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

216704 (NC)

Practice address

107 Industrial Dr Ste C
Louisburg, NC 27549-2371

Phone

(919) 496-2533

NPI assigned

Jul 28, 2011

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Specialties & licenses

Addresses

Other names

• Ms. Megan Ann Marie Myers Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 8, 2017.

{
    "created_epoch": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1578841276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 INDUSTRIAL DR STE C",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492371",
            "telephone_number": "919-496-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 INDUSTRIAL DR STE C",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492371",
            "telephone_number": "919-496-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLIET",
        "first_name": "MEGAN",
        "middle_name": "MYERS",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-28",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "216704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "MYERS",
            "middle_name": "ANN MARIE",
            "prefix": "MS.",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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