Individual provider Active NPI

Kasie A Ballard, MS, OTR/L

  • Occupational Therapist
  • Evansville, IN
National Provider Identifier
1619228772
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31005330A Issued in IN
Practice address
4101 Rodenberg Ave
Evansville, IN 47720-6230
Phone
(812) 228-6896
NPI assigned
Sep 28, 2012
Last updated
Jul 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 264002 KY
Occupational Therapist 225X00000X 31005330A IN Primary
Pediatric Occupational Therapist 225XP0200X NU

Addresses

Primary practice location

4101 Rodenberg Ave
Evansville, IN 47720-6230

Mailing address

4101 Rodenberg Ave
Evansville, IN 47720-6230
Phone (812) 228-6896

Other names 1

  • Kasie A Bennett Former name

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
Master of Science

State licenses

LicenseStateTypeSpecialty
31005330AINMDOccupational Therapist
264002KYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Evolve Early Intervention Pediatrics CurrentSince Oct 24, 2021 Accepting new patients
Ballard Pediatrics Occupational Therapist CurrentSince Jul 24, 2022 Accepting new patients
Evolve Pediatrics, LLC Occupational Therapist Past Accepting new patients

Locations

2480 US Highway 41 N
Ste 80
Henderson, KY 42420
Phone (270) 823-3875

Organizations & group practices 3

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": "1348790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1619228772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 RODENBERG AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477206230",
            "telephone_number": "812-228-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 RODENBERG AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477206230",
            "telephone_number": "812-228-6896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "KASIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-28",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "264002",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31005330A",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KASIE",
            "last_name": "BENNETT",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.