Individual provider Active NPI

Kristin Johnston Ballard, DNP

  • Family Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1861956104
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5011416 Issued in NC
Practice address
5211 S College Rd
Wilmington, NC 28412-2209
Phone
(910) 772-6290
Fax
(910) 341-3429
NPI assigned
Jan 30, 2019
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5011416 NC
Family Nurse Practitioner 363LF0000X 5011416 NC Primary

Addresses

Primary practice location

5211 S College Rd
Wilmington, NC 28412-2209

Mailing address

1202 Medical Center Dr
Wilmington, NC 28401-7307
Phone (910) 617-6705

Other names 1

  • Kristin Elizabeth Johnston Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190514003209 NC Practitioner - Nurse Practitioner 9931442936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians
Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Practice addresses (Care Compare)

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

5211 S College Rd
Wilmington, NC 28412-2209
Phone (910) 341-1540

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wha Medical Clinic PLLC Current Accepting new patients
Wilmington Health PLLC CurrentSince Feb 8, 2023 Accepting new patients
Wilmington ASC LLC CurrentSince May 4, 2021 Accepting new patients
Wilmington Health PLLC CurrentSince May 4, 2021 Accepting new patients

Locations

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

4320 Henson Dr
Wilmington, NC 28405
Phone (910) 763-2072

5211 College Rd S
Wilmington, NC 28412
Phone (910) 772-6290

Interoperability endpoints

  • Direct secure messaging: kristin.johnston.p1@direct.wilmingtonhealth.nextgenshare.com

Organizations & group practices 4

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 1

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": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1861956104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-617-6705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5211 S COLLEGE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122209",
            "telephone_number": "910-772-6290",
            "fax_number": "910-341-3429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "KRISTIN",
        "middle_name": "JOHNSTON",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-30",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011416",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5011416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "JOHNSTON",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.