Mary Bragg Ballou, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

299 Issued in NH

Practice address

69C Island St
Keene, NH 03431-3529

Phone

(603) 354-6700

NPI assigned

Jan 2, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Dartmouth-Hitchcock Clinic

  • Internal Medicine Physician
  • Lebanon, NH
  • NPI 1548210198
  NPD (past)
• Mary Hitchcock Memorial Hospital

  • Community/Retail Pharmacy
  • Keene, NH
  • NPI 1033761739
  NPD (past)

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

{
    "created_epoch": "1136160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1730167693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69C ISLAND ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034313529",
            "telephone_number": "603-354-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69C ISLAND ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034313529",
            "telephone_number": "603-354-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLOU",
        "first_name": "MARY",
        "middle_name": "BRAGG",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NH",
            "license": "299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "299",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Everett M Bacon, MD
• Linda J Baker, PH.D.
• Reuben Baker, MD
• Samantha Baker
• Sarah E Baker
• Wayne Balnis
• Mia Balsom, DMD
• Margo H Banks
• Barbara B. Dematteo, PT
• Cassidy Anne Barcome

• All providers in Keene, NH
• Psychologist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.