Gary Ballard, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

G26847 Issued in CA

Practice address

2740 W Lake Mendocino Dr
Ukiah, CA 95482-3044

Phone

(707) 462-9028

NPI assigned

Jul 20, 2006

Last updated

Jun 6, 2011By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1902826860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 W LAKE MENDOCINO DR",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954823044",
            "telephone_number": "707-462-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 W LAKE MENDOCINO DR",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954823044",
            "telephone_number": "707-462-9028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "GARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G26847",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR-14824",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53838068",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tawny Bailey
• Alicia Bainbridge, MA - MFT
• Erin Bainbridge, N.P.
• Beverly Baker
• Jane D Baldwin
• Phoebe Janelle Ballard, BCBA
• Ashley Rochelle Balletto, FNP
• Aldis Baltins, MD
• Katy Leanne Bandy, LCSW
• Isabel Barajas, ASW

• Diagnostic Radiology Physician in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.