Individual provider Active NPI

Christian Ballast, MD

  • Internal Medicine Physician
  • Shelbyville, IN
National Provider Identifier
1720025174
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01038703A Issued in IN
Practice address
2158 Intelliplex Dr
Suite 200
Shelbyville, IN 46176-8846
Phone
(317) 392-3651
Fax
(317) 398-0538
NPI assigned
Jun 1, 2006
Last updated
Nov 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01038703A IN Primary
Pediatrics Physician 208000000X 01038703A IN

Addresses

Primary practice location

2158 Intelliplex Dr
Suite 200
Shelbyville, IN 46176-8846

Mailing address

1626 E State Road 44
Ste a
Shelbyville, IN 46176-4057
Phone (317) 421-2012

Other identifiers 1

IdentifierTypeStateIssuer
100317710MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040928000805 IN Practitioner - Internal MedicinePractitioner - Family Practice 3476522301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Michigan Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Major HospitalGroup PAC ID 0446167415, 100 clinicians

Practice addresses (Care Compare)

2451 Intelliplex Dr
Shelbyville, IN 46176-8580
Phone (317) 392-3211

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01038703AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
X-Ray Physicians of Shelbyville PC Current Accepting new patients
Major Hospital CurrentSince Jul 26, 1990 Accepting new patients
Major Hospital CurrentSince Jul 26, 1990 Accepting new patients
River Crossing Emergency Physicians Past Accepting new patients
Major Hospital Past Accepting new patients
Midwest Medical Management, P.C. Internal Medicine Past Accepting new patients
Major Multispecialty Associates Internal Medicine Past Accepting new patients
Nufinity, LLC Past Accepting new patients
Major Hospital Past Accepting new patients
Major Medical Group LLC Past Accepting new patients
Rush Memorial Hospital Past Accepting new patients
Midwest Medical Management, P.C. Past Accepting new patients

Locations

275 W 12th St
Peru, IN 46970
Phone (317) 472-8022

275 W 12th St
Ste 105
Peru, IN 46970
Phone (765) 472-8000

110 E 13th St
Rushville, IN 46173
Phone (765) 932-7063

1300 N Main St
Rushville, IN 46173
Phone (317) 802-3106

1640 E State Road 44
Shelbyville, IN 46176
Phone (317) 392-4300

1640 E State Road 44
Ste B
Shelbyville, IN 46176
Phone (317) 392-3779

2158 Intelliplex Dr
Ste 200
Shelbyville, IN 46176
Phone (317) 392-3651

2451 Intelliplex Dr
Shelbyville, IN 46176
Phone (317) 392-3211

2451 Intelliplex Dr
#210
Shelbyville, IN 46176
Phone (317) 421-1914

2451 Intelliplex Dr
Ste 24
Shelbyville, IN 46176
Phone (317) 398-7337

2451 Intelliplex Dr
Ste 240
Shelbyville, IN 46176
Phone (317) 398-7337

30 W Rampart St
Ste 170
Shelbyville, IN 46176
Phone (317) 382-3651

30 W Rampart St
Ste 200
Shelbyville, IN 46176
Phone (317) 398-0121

30 W Rampart St
Ste 250
Shelbyville, IN 46176
Phone (317) 398-7337

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 12

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1720025174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 E STATE ROAD 44",
            "address_2": "STE A",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461764057",
            "telephone_number": "317-421-2012",
            "fax_number": "317-398-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2158 INTELLIPLEX DR",
            "address_2": "SUITE 200",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768846",
            "telephone_number": "317-392-3651",
            "fax_number": "317-398-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLAST",
        "first_name": "CHRISTIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01038703A",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01038703A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100317710",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IN

Sources for this page

Verify at the official NPI Registry.