Connie Ball MD LLC
Organization Active NPI Internal Medicine Physician · Springboro, OH
NPI 1679765663 · NPPES record last updated Apr 20, 2008
Key facts
- NPI
- 1679765663
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 35067559 (OH)
- Legal business name
- CONNIE BALL MD LLC
- Practice address
- 84 N Main St
Springboro, OH 45066 - Phone
- (937) 748-5346
- Fax
- (937) 748-5369
- NPI assigned
- Aug 14, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Connie Sue Ball
- Title
- Physician Owner
- Phone
- (937) 748-5346
Practitioners 1
-
Connie S Ball, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040618000368 | OH | Part B Supplier - Clinic/Group Practice | 7810972510 |
Receives reassigned benefits from 1 practitioner Practice locations: Springboro, OH |
National Provider Directory
Locations
84 N Main St
Springboro, OH 45066
Phone (937) 748-5346
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | 35067559 | OH | Yes |
Addresses
Primary practice location
84 N Main St
Springboro, OH 45066
Mailing address
84 N Main St
Springboro, OH 45066
Phone (937) 748-5346
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 363899941026 | Other | CARESOURCE | |
| 3996090680 | Other | WORKERS COMPENSATION | |
| 399609068003 | Other | MEDICAL MUTUAL | |
| 0112593 | Other | UNITED HEALTH CARE | |
| 5668002 | Other | AETNA | |
| DE3333 | Other | RR MCR | |
| 000000338258 | Other | ANTHEM | |
| P00286099 | Other | RR MCR | |
| D67559 | Other | HUMANA | |
| 0168894 | Medicaid | OH |
Other providers in Springboro, OH
- Clearcreek TWP Trustees
- Jessica L Click
- Courtney Coe
- Jamie Combs
- Connect Hearing, Inc.
- Cory B. Sellers, DDS, LLC, Springboro
- Christina Couch
- Melanie Courtney
- Shannon M Craig
- Carol V Crippen
All providers in Springboro, OH · Internal Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2008. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.