Laura Margaret Ballard, APRN
Individual provider Active NPI Nurse Practitioner · West Memphis, AR
NPI 1629620190 · NPPES record last updated Jul 15, 2019
Key facts
- NPI
- 1629620190
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 25853 (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
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210304002034 | TN | Practitioner - Nurse Practitioner | 3678989332 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25853 | TN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urgent Care for Children, PLLC | Nurse Practitioner | Current |
Accepting new patients |
| Pediatric Associates of West Memphis, PLC | Past |
Accepting new patients | |
| Pediatric Associates of W MPHS | Past |
Accepting new patients | |
| Pediatric Emergency Specialists, PC | Past | 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
- lballard29189@mlh.direct-ci.com
- lballard@pediatricassociates.biz
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 25853 | TN | Yes |
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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | LBallard@pediatricassociates.biz |
Other providers in West Memphis, AR
- Lori Bacon
- Jasmine Bailey
- Bailey'S Mobile Lab
- Cotrena Rae Baker
- Zachary Tyler Baker
- Holli Nicole Banks-Giles
- Brea Banks
- Miya D Banks
- Baptist Memorial Hospital - Crittenden Inc
- Barbara Sue Barker
All providers in West Memphis, AR · Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.