Individual provider Active NPI

Renea Lynne Ball

  • Nurse Practitioner
  • Marietta, OH
National Provider Identifier
1609430214
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LE-00028116 Issued in OH
Practice address
416 Front St
Marietta, OH 45750-2124
Phone
(740) 516-6062
Fax
(740) 371-7778
NPI assigned
Apr 29, 2019
Last updated
Apr 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X LE-00028116 OH Primary

Addresses

Primary practice location

416 Front St
Marietta, OH 45750-2124

Mailing address

555 Cajon St
Redlands, CA 92373-5980
Phone (469) 217-4118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190829004065 OH Practitioner - Nurse Practitioner 6002144953 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
LE-00028116OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Care Associates Urgent Care and Wellness Center, LLC CurrentSince Jun 19, 2019 Accepting new patients

Locations

416 Front St
Marietta, OH 45750
Phone (740) 236-4131

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18451/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1609430214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 CAJON ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735980",
            "telephone_number": "469-217-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 FRONT ST",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457502124",
            "telephone_number": "740-516-6062",
            "fax_number": "740-371-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALL",
        "first_name": "RENEA",
        "middle_name": "LYNNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "LE-00028116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

Verify at the official NPI Registry.