Blair Andrew Ball

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP11340 Issued in AZ

Practice address

15235 N Dysart Rd
El Mirage, AZ 85335-9738

Phone

(602) 569-3999

Fax

(602) 569-3887

NPI assigned

Mar 6, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Clinica la Familia PCGroup PAC ID 4082694781, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clinica la Familia, PC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1780668921
  Medicare reassignment Care Compare group
• Desert Kidney Associates PLC

  • Nephrology Physician
  • Mesa, AZ
  • NPI 1144372905
  NPD (past)
• Palm View Health and Wellness LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Goodyear, AZ
  • NPI 1457040594
  NPD (past)

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

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1891297776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 E WILLETTA ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062935",
            "telephone_number": "602-569-3999",
            "fax_number": "602-569-3887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15235 N DYSART RD",
            "city": "EL MIRAGE",
            "state": "AZ",
            "postal_code": "853359738",
            "telephone_number": "602-569-3999",
            "fax_number": "602-569-3887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1315 W Southern Ave",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852824519",
            "country_code": "US",
            "telephone_number": "602-569-3999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13402 N 32nd St Ste 5",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850326047",
            "country_code": "US",
            "telephone_number": "602-569-3999",
            "fax_number": "602-569-3887",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "616 E Southern Ave",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852044941",
            "country_code": "US",
            "telephone_number": "602-569-3999",
            "fax_number": "602-569-3887",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7734 N 59th Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853017816",
            "country_code": "US",
            "telephone_number": "602-569-3999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 E Cottonwood Ln Ste 12",
            "address_purpose": "LOCATION",
            "city": "Casa Grande",
            "state": "AZ",
            "postal_code": "851222551",
            "country_code": "US",
            "telephone_number": "602-569-3999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1533 E Willetta St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "85006",
            "country_code": "US",
            "telephone_number": "602-569-3999",
            "fax_number": "602-569-3887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALL",
        "first_name": "BLAIR",
        "middle_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-06",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "57937",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421665",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Big John Group Home

• Family Nurse Practitioner in El Mirage, AZ
• Providers in El Mirage, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; 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.
• 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.