Jesse Ballard, FNP-C
Individual provider Active NPI Nurse Practitioner · St George, UT
NPI 1629675699 · NPPES record last updated Apr 15, 2026
Key facts
- NPI
- 1629675699
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 11985380-4405 (UT)
- Practice address
- 1380 E Medical Center Dr
St George, UT 84790-2123 - Phone
- (435) 251-2500
- NPI assigned
- Oct 2, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ihc Health Services Inc
Practice addresses (Care Compare)
1380 E Medical Ctr Dr
St George, UT 84790-2123
Phone (435) 251-1000
Hospital & facility affiliations
- St. George Regional Hospital
- Intermountain Health Cedar City Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- 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 |
|---|---|---|---|---|
| I20201130000280 | UT | Practitioner - Nurse Practitioner | 3870904600 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2161573 | ID | MD | Nurse Practitioner |
| AP61095878 | WA | MD | Nurse Practitioner |
| 11985380-4405 | UT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current |
Accepting new patients | |
| Ihc Health Services Inc | Current |
Accepting new patients | |
| Kootenai Health, Inc. | Past | Accepting new patients | |
| Kootenai Health, Inc. | Nurse Practitioner | Past | Accepting new patients |
| Ihc Health Services Inc | Past | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992
1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP61095878 | WA | |
| Nurse Practitioner | 363L00000X | 2161573 | ID | |
| Nurse Practitioner | 363L00000X | 11985380-4405 | UT | Yes |
| Family Nurse Practitioner | 363LF0000X | 11985380-4405 | UT |
Addresses
Primary practice location
1380 E Medical Center Dr
St George, UT 84790-2123
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other practice location 1
700 W Ironwood Dr Ste 120
Coeur D Alene, ID 83814-4405
Phone (208) 625-3640
Other practice location 2
1055 N 500 W Ste 205
Provo, UT 84604-3305
Phone (801) 354-8225
Other practice location 3
1410 N Samantha Rd
Liberty Lake, WA 99019-8626
Phone (801) 441-9534
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguest_Service | Other | Bluemark LLC / Office Ally |
| Direct Messaging Address | medreview@reverehealth.com | Central Utah Clinic, P.C. |
Other providers in St George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2026. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.