Individual provider Active NPI

Sharon P. Balcells, M.D.

  • Internal Medicine Physician
  • Temple, TX
National Provider Identifier
1730148693
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K6809 Issued in TX
Practice address
4501 S General Bruce Dr
Ste 75
Temple, TX 76502-1469
Phone
(254) 743-1628
NPI assigned
Mar 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K6809 TX Primary

Addresses

Primary practice location

4501 S General Bruce Dr
Ste 75
Temple, TX 76502-1469

Mailing address

4501 S General Bruce Dr
Ste 75
Temple, TX 76502-1469
Phone (254) 743-1628

Other identifiers 3

IdentifierTypeStateIssuer
110211238OtherTXRR/MEDICARE
0465064-01MedicaidTX
88391KOtherTXBLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140825002197 TX Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2961540364

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K6809TXMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1730148693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 S GENERAL BRUCE DR",
            "address_2": "STE 75",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765021469",
            "telephone_number": "254-743-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 S GENERAL BRUCE DR",
            "address_2": "STE 75",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765021469",
            "telephone_number": "254-743-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALCELLS",
        "first_name": "SHARON",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K6809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR/MEDICARE",
            "identifier": "110211238",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0465064-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "88391K",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.