Ryan James Ballard, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Rolla, MO
NPI 1780247320 · NPPES record last updated Apr 18, 2019
Key facts
- NPI
- 1780247320
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 2019011200 (MO)
- Practice address
- 1000 W 10TH St
Rolla, MO 65401-2905 - Phone
- (573) 364-9000
- NPI assigned
- Apr 18, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Grant County Public Hospital District 1
Public Hospital District No 1 of Mason County
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
- Samaritan Hospital
- Mason General Hospital & Family of Clinics
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210114001663 | WA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 3971846262 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grant County Public Hospital District 1 | Current | Accepting new patients | |
| Public Hospital District No 1 of Mason County Wa | Current |
Accepting new patients | |
| Grant County Public Hospital District 1 | Current |
Accepting new patients | |
| Public Hospital District No 1 of Mason County | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Grant County Public Hospital District 1 | Current |
Accepting new patients |
Locations
400 10th St E
Waconia, MN 55387
2000 S Clover Dr
Moses Lake, WA 98837
Phone (509) 765-5606
801 E Wheeler Rd
Moses Lake, WA 98837
Phone (509) 765-5606
660 S Coolidge St
Moses Lake, WA 98837
901 Mountain View Dr
Bldg 1
Shelton, WA 98584
Phone (360) 426-1611
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 2019011200 | MO | Yes |
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
Other providers in Rolla, MO
- Mary Jane Aufdengarten
- Mathew S. Ausmus
- Terry Bryan Austin
- Amanda L Bahr
- Casey Rhae Ball
- Steven R Ballard
- Mahmoud Ballout
- Tasha Baney
- Amanda Christine Banks
- Jennifer Anne Barclay
All providers in Rolla, MO · Certified Registered Nurse Anesthetist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.