Conrad D Ballecer MD PLLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

CONRAD D BALLECER MD PLLC

Practice address

14155 N 83Rd Ave Ste A105
Peoria, AZ 85381-5640

Phone

(623) 486-7700

Fax

(623) 486-7703

NPI assigned

Nov 19, 2012

Last updated

Nov 19, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Conrad D Ballecer, MD

Title

President

Phone

(623) 486-7700

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1831433572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14155 N 83RD AVE STE A105",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815640",
            "telephone_number": "623-486-7700",
            "fax_number": "623-486-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14155 N 83RD AVE STE A105",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815640",
            "telephone_number": "623-486-7700",
            "fax_number": "623-486-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONRAD D BALLECER MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "BALLECER",
        "authorized_official_first_name": "CONRAD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-486-7700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.