Individual provider Active NPI

Braxton Ball

  • Registered Nurse
  • Sun City West, AZ
National Provider Identifier
1780366211
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
59358 Issued in ID
Practice address
14502 W Meeker Blvd
Sun City West, AZ 85375-5282
Phone
(623) 524-4000
NPI assigned
Aug 3, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163W00000X 59358 ID Primary

Addresses

Primary practice location

14502 W Meeker Blvd
Sun City West, AZ 85375-5282

Mailing address

1586 N 885 E
Shelley, ID 83274-3201
Phone (208) 932-6411

Other practice location 1

10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Phone (623) 832-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240620003430 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113460965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Hospital LLC Single Specialty CurrentSince Apr 18, 2024 Accepting new patients

Locations

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

Organizations & group practices 1

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 2

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": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1780366211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1586 N 885 E",
            "city": "SHELLEY",
            "state": "ID",
            "postal_code": "832743201",
            "telephone_number": "208-932-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14502 W MEEKER BLVD",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755282",
            "telephone_number": "623-524-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10401 W Thunderbird Blvd",
            "address_purpose": "LOCATION",
            "city": "Sun City",
            "state": "AZ",
            "postal_code": "853513004",
            "country_code": "US",
            "telephone_number": "623-832-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALL",
        "first_name": "BRAXTON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-03",
        "last_updated": "2023-08-03",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "59358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.