Individual provider Active NPI

Lillian Rochelle Ballard, CRNP

  • Family Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1891440038
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R206636 Issued in MD
Practice address
223 Phillip Morris Dr
Salisbury, MD 21804-1923
Phone
(410) 548-1747
Fax
(410) 548-3783
NPI assigned
Feb 16, 2022
Last updated
Jul 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R206636 MD Primary

Addresses

Primary practice location

223 Phillip Morris Dr
Salisbury, MD 21804-1923

Mailing address

PO Box 1978
Salisbury, MD 21802-1978
Phone (410) 749-1015

Other identifiers 1

IdentifierTypeStateIssuer
119591300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20220816001972 MD Practitioner - Nurse Practitioner 3274916754 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Three Lower Counties Community Services, Inc. CurrentSince Aug 28, 2022 Accepting new patients
Three Lower Counties Community Services Inc Current Accepting new patients
Three Lower Counties Community Services, Inc. CurrentSince Aug 28, 2022 Accepting new patients
Three Lower Counties Community Services, Inc. Past Accepting new patients

Locations

1817 Old Virginia Rd
Pocomoke City, MD 21851
Phone (410) 651-4040

12137 Elm St
Princess Anne, MD 21853
Phone (410) 651-1000

12145 Elm St
Princess Anne, MD 21853
Phone (410) 651-2204

223 Phillip Morris Dr
Salisbury, MD 21804
Phone (410) 546-2424

31481 Old Ocean City Rd
Salisbury, MD 21804
Phone (410) 677-3936

32033 Beaver Run Dr
Salisbury, MD 21804
Phone (410) 860-6600

Interoperability endpoints

  • Direct secure messaging: lillian.ballard.1@3167.direct.athenahealth.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.

NPI Registry JSON

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1891440038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218021978",
            "telephone_number": "410-749-1015",
            "fax_number": "410-749-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 PHILLIP MORRIS DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218041923",
            "telephone_number": "410-548-1747",
            "fax_number": "410-548-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "LILLIAN",
        "middle_name": "ROCHELLE",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R206636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.