NPIMap

Individual provider Active NPI

Ryan James Ballard, CRNA

  • Certified Registered Nurse Anesthetist
  • Rolla, MO
National Provider Identifier
1780247320
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2019011200 Issued in MO
Practice address
1000 W 10TH St
Rolla, MO 65401-2905
Phone
(573) 364-9000
NPI assigned
Apr 18, 2019
Last updated
Apr 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2019011200 MO Primary

Addresses

Primary practice location

1000 W 10TH St
Rolla, MO 65401-2905

Mailing address

11528 Pine Forest Dr
Rolla, MO 65401-5427
Phone (509) 855-2116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210114001663 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3971846262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2000 S Clover Dr
Moses Lake, WA 98837-4417
Phone (509) 765-5606

901 Mountain View Dr
Suite 1
Shelton, WA 98584-4401
Phone (360) 427-3625

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 1 of Mason County Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2025 Accepting new patients
Public Hospital District No 1 of Mason County Wa CurrentSince Aug 1, 2025 Accepting new patients
Grant County Public Hospital District 1 CurrentSince Dec 29, 2020 Accepting new patients
Grant County Public Hospital District 1 Current Accepting new patients
Grant County Public Hospital District 1 CurrentSince Dec 29, 2020 Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

2000 S Clover Dr
Moses Lake, WA 98837
Phone (509) 765-5606

660 S Coolidge St
Moses Lake, WA 98837

801 E Wheeler Rd
Moses Lake, WA 98837
Phone (509) 765-5606

901 Mountain View Dr
Bldg 1
Shelton, WA 98584
Phone (360) 426-1611

Organizations & group practices 5

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 6

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": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1780247320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11528 PINE FOREST DR",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654015427",
            "telephone_number": "509-855-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-364-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "RYAN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2019011200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.