Individual provider Active NPI

Laura Margaret Ballard, APRN

  • Nurse Practitioner
  • West Memphis, AR
National Provider Identifier
1629620190
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
25853 Issued in TN
Practice address
108 W Tyler Ave
West Memphis, AR 72301-4221
Phone
(870) 732-1191
Fax
(870) 732-4091
NPI assigned
Jul 15, 2019
Last updated
Jul 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 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 25853 TN Primary

Addresses

Primary practice location

108 W Tyler Ave
West Memphis, AR 72301-4221

Mailing address

108 W Tyler Ave
West Memphis, AR 72301-4221
Phone (870) 732-1191

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address LBallard@pediatricassociates.biz

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20210304002034 TN Practitioner - Nurse Practitioner 3678989332 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25853TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care for Children, PLLC Nurse Practitioner CurrentSince Jan 25, 2021 Accepting new patients
Children's Urgent Care, LLC Nurse Practitioner PastSince Nov 30, 2020 Accepting new patients
Pediatric Associates of West Memphis, PLC PastSince Jul 25, 2019 Accepting new patients
Pediatric Emergency Specialists, PC Past Accepting new patients
Pediatric Associates of W MPHS PastSince Jul 25, 2019 Accepting new patients

Locations

500 Cahaba Park Cir
Ste 100
Birmingham, AL 35242
Phone (205) 848-2273

604 W Poplar Ave
Collierville, TN 38017
Phone (901) 457-0541

5215 Highway 153
Ste 105
Hixson, TN 37343
Phone (423) 664-1151

Interoperability endpoints

  • Direct secure messaging: lballard@pediatricassociates.biz
  • Direct secure messaging: lballard29189@mlh.direct-ci.com

Organizations & group practices 5

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": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1629620190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W TYLER AVE",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014221",
            "telephone_number": "870-732-1191",
            "fax_number": "870-732-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W TYLER AVE",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014221",
            "telephone_number": "870-732-1191",
            "fax_number": "870-732-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "LAURA",
        "middle_name": "MARGARET",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "25853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "LBallard@pediatricassociates.biz",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "108 W Tyler Ave",
            "city": "West Memphis",
            "state": "AR",
            "country_code": "US",
            "postal_code": "723014221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Memphis, AR

Sources for this page

Verify at the official NPI Registry.