Individual provider Active NPI

Bruce Ballard, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
National Provider Identifier
1821367863
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
706059 Issued in TX
Practice address
4100 International PLZ
Suite 600
Fort Worth, TX 76109-4820
Phone
(817) 529-1157
Fax
(817) 877-0350
NPI assigned
Dec 20, 2011
Last updated
Dec 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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 706059 TX Primary

Addresses

Primary practice location

4100 International PLZ
Suite 600
Fort Worth, TX 76109-4820

Mailing address

4100 International PLZ
Suite 600
Fort Worth, TX 76109-4820
Phone (817) 529-1157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.16 of 100Reported as group
Quality
83.25
Promoting interoperability
92
Improvement activities
40
Cost
77.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
706059TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Panhandle Eye Group, LLP CurrentSince Feb 1, 2015 Accepting new patients

Locations

7400 Fleming Ave
Amarillo, TX 79106
Phone (806) 331-2510

7310 Fleming Ave
Amarillo, TX 79106
Phone (806) 354-2591

Interoperability endpoints

  • Direct secure messaging: bruce.ballard@direct.paneye.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1821367863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 INTERNATIONAL PLZ",
            "address_2": "SUITE 600",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094820",
            "telephone_number": "817-529-1157",
            "fax_number": "817-877-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 INTERNATIONAL PLZ",
            "address_2": "SUITE 600",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094820",
            "telephone_number": "817-529-1157",
            "fax_number": "817-877-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "BRUCE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-20",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "706059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.