Active NPI
Mitchell Ballard, DO
- Student in an Organized Health Care Education/Training Program
- Salem, VA
National Provider Identifier
1750140414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1900 Electric Rd
Salem, VA 24153-7474 - Phone
- (540) 776-4000
- NPI assigned
- Mar 15, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1900 Electric Rd
Salem, VA 24153-7474
Mailing address
1900 Electric Rd
Salem, VA 24153-7474
Phone (540) 776-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240606002487 | VA | Order and Referring Only - Internal Medicine | 2163964040 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710460800000",
"number": "1750140414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 ELECTRIC RD",
"city": "SALEM",
"state": "VA",
"postal_code": "241537474",
"telephone_number": "540-776-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 ELECTRIC RD",
"city": "SALEM",
"state": "VA",
"postal_code": "241537474",
"telephone_number": "540-776-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLARD",
"first_name": "MITCHELL",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-15",
"last_updated": "2024-03-15",
"certification_date": "2024-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.