Theresa Lee Balloy

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

2261025 Issued in MN

Practice address

2540 Onyx Dr
Shakopee, MN 55379-2769

Phone

(743) 913-1658

NPI assigned

Oct 9, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1669253308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23341 ARROWHEAD ST NW",
            "city": "SAINT FRANCIS",
            "state": "MN",
            "postal_code": "550709587",
            "telephone_number": "763-913-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 ONYX DR",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553792769",
            "telephone_number": "743-913-1658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLOY",
        "first_name": "THERESA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2261025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Lea Bach, LPN
• Kari Ann Badali, PA-C
• Addee Badhwa, RT(R)
• Premm Badhwa
• Michelle Bahr, LADC, CPP
• Amber C. Barnes, MSW, LICSW
• Carmen Barnes, LICSW
• Karyn E Barry, CRNA
• Deborah A Battles, MA, LP
• Danielle Bauman

• All providers in Shakopee, MN
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.