Marianna Boyles Ballard, NP
Individual provider Active NPI Acute Care Nurse Practitioner · Cookeville, TN
NPI 1871979856 · NPPES record last updated Apr 7, 2025
Key facts
- NPI
- 1871979856
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- 20392 (TN)
- Practice address
- 1 Medical Center Blvd
Cookeville, TN 38501-4294 - Phone
- (931) 783-2770
- Fax
- (931) 525-1176
- NPI assigned
- Aug 3, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Relias Emergency Medicine Specialists of West Point, LLC
Relias Hospitalist Medicine Specialists of West Point LLC
RH Emergency Medicine of Och Regional LLC
RH Hospitalist Medicine of Och Regional LLC
Practice addresses (Care Compare)
150 Medical Ctr Dr
West Point, MS 39773-0428
Phone (662) 495-2300
400 Hospital Rd
Starkville, MS 39759-2163
Phone (662) 432-4106
Hospital & facility affiliations
- Baptist Memorial Hospital-Oktibbeha County
- Clay County Medical Corporation
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180102001064 | MS | Practitioner - Nurse Practitioner | 1456660851 | Reassigns benefits to 10 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Relias Hospitalist Medicine Specialists of Tupelo LLC | Current |
Accepting new patients | |
| North Mississippi Medical Center | Current | Accepting new patients | |
| Urology Clinic of Meridian, P.a. | Current | Accepting new patients | |
| RH Emergency Medicine of Och Regional LLC | Current |
Accepting new patients | |
| RH Hospitalist Medicine of Och Regional LLC | Current |
Accepting new patients | |
| Relias Hospitalist Medicine Specialists of Pontotoc LLC | Current |
Accepting new patients | |
| Relias Hospitalist Medicine Specialists of West Point LLC | Current |
Accepting new patients | |
| Anderson Physician Alliance, Inc. | Current |
Accepting new patients | |
| Relias Hospitalist Medicine Specialists of Amory LLC | Current |
Accepting new patients | |
| RH Hospitalist Medicine of Philadelphia LLC | Current |
Accepting new patients | |
| Relias Emergency Medicine Specialists of West Point, LLC | Current |
Accepting new patients | |
| Cookeville Regional Medical Center | Past | Accepting new patients |
Locations
1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111
1102 Constitution Ave
Meridian, MS 39301
Phone (601) 693-2511
2124 14th St
Meridian, MS 39301
Phone (601) 483-8811
1600 22nd Ave
Meridian, MS 39301
Phone (601) 483-5322
1001 Holland Ave
Philadelphia, MS 39350
Phone (601) 663-1200
176 S Main St
Pontotoc, MS 38863
Phone (601) 489-5510
400 Hospital Rd
Starkville, MS 39759
Phone (662) 323-4320
830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136
150 Medical Center Dr
West Point, MS 39773
Phone (601) 494-2321
Interoperability endpoints
- mariannaballard@nmhs.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 20392 | TN | Yes |
Addresses
Primary practice location
1 Medical Center Blvd
Cookeville, TN 38501-4294
Mailing address
127 N Oak Ave
Suite D
Cookeville, TN 38501-2435
Phone (931) 783-5857
Other practice location 1
1102 Constitution Ave
Meridian, MS 39301-4001
Phone (601) 703-5000
Other practice location 2
2124 14th St
Meridian, MS 39301-4040
Phone (601) 553-6000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q016299 | Medicaid | TN | |
| 6047498 | Other | TN | BCBS |
| 7100421080 | Medicaid | KY |
Other providers in Cookeville, TN
- Lyda Bailey
- Sandra L Bailiff
- Jeri Lynn Baker
- Whitney Carol Baker
- Emily Nichole Ball
- Kyrsten Ann Bandholz
- Judy Barclay
- Melinda Barker-Mutchmore
- Melanie Susanne Barker
- Betty Ann Barnes
All providers in Cookeville, TN · Acute Care Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.