Mary Beth Balle, PMHCNS-BC, RN

Primary specialty

Child & Adolescent Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0807X

License

71003908A Issued in IN

Practice address

350 S Landmark Ave
Bloomington, IN 47403-5001

Phone

(812) 335-2434

Fax

(812) 335-7604

NPI assigned

Oct 11, 2011

Last updated

Dec 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Registered Nurse

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mballe@direct.iuhealth.org

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.

• Walkabout LLC

  • Community/Behavioral Health Agency
  • Bloomington, IN
  • NPI 1821335563
  NPD (past) Authorized official

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1841575735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035001",
            "telephone_number": "812-335-2434",
            "fax_number": "812-335-7604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 S Walnut St Ste 17",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474046118",
            "country_code": "US",
            "telephone_number": "812-671-0057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALLE",
        "first_name": "MARY",
        "middle_name": "BETH",
        "credential": "PMHCNS-BC, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "IN",
            "license": "71003908A",
            "primary": true
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71003908A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28160285A",
            "primary": false
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "IN",
            "license": "2010016860",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MBALLE@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "350 S Landmark Ave",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474035001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MBALLE@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "350 S Landmark Ave",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474035001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erin L Baldomero, MA, LMFTA
• Dawn Nichole Baldwin, PHARM.D.
• Jessica Rochelle Baldwin, BSN, RN, CEN, SANE
• Jamie Carol Bales, M.D.
• Steven I Ball, OD
• Anna Ballenger
• Christina L Bame, LCSW
• Kylee Banks
• Eric A Bannec, MD
• Linda Louise Bannister

• Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.