Beth Ann Ballinger, OTR

Individual provider Active NPI Occupational Therapist · Dandridge, TN

NPI 1699818005 · NPPES record last updated Dec 13, 2016

Key facts

NPI
1699818005
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
1216 (TN)
Practice address
572 Sam Martin Rd
Dandridge, TN 37725-4120
Phone
(865) 382-4209
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20080710000725 TN Practitioner - Occupational Therapist in Private Practice 1052483823

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Health Systems Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1216 TN Yes

Addresses

Primary practice location

572 Sam Martin Rd
Dandridge, TN 37725-4120

Mailing address

572 Sam Martin Rd
Dandridge, TN 37725-4120
Phone (865) 382-4209

Other identifiers

IdentifierTypeStateIssuer
Q023565MedicaidTN
5440690MedicaidTN
4107082OtherTNBCBS PROVIDER NUMBER

Other providers in Dandridge, TN

All providers in Dandridge, TN · Occupational Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.