Individual provider Active NPI

Charlotte D Ballard, MSN, ENP-BC

  • Primary Care Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1902893324
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP107832 Issued in TX
Practice address
13300 Old Blanco Rd # 340
San Antonio, TX 78216-7737
Phone
(210) 600-4105
NPI assigned
Sep 30, 2005
Last updated
Mar 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP107832 TX
Family Nurse Practitioner 363LF0000X AP107832 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP107832 TX
Primary Care Nurse Practitioner 363LP2300X AP107832 TX Primary

Addresses

Primary practice location

13300 Old Blanco Rd # 340
San Antonio, TX 78216-7737

Mailing address

13300 Old Blanco Rd # 340
San Antonio, TX 78216-7737
Phone (210) 600-4105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050811000683 TX Practitioner - Nurse Practitioner 9436188232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13300 Old Blanco Rd
Suite 340
San Antonio, TX 78216-7737
Phone (210) 600-4105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP107832TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Steepletop Emergency Physicians Multi-Specialty Past Accepting new patients
University of Houston Past Accepting new patients
Texas Em-I Medical Services PA Multi-Specialty Past Accepting new patients
New Medical Horizons II, LTD. Multi-Specialty Past Accepting new patients
Transitioncare Medical Group LLC Multi-Specialty Past Accepting new patients
Emcare Iah Emergency Physicians PLLC Multi-Specialty Past Accepting new patients
Ep Descant II Mdpa Multi-Specialty Past Accepting new patients

Organizations & group practices 9

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1902893324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13300 OLD BLANCO RD # 340",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782167737",
            "telephone_number": "210-600-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13300 OLD BLANCO RD # 340",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782167737",
            "telephone_number": "210-600-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "CHARLOTTE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "MSN, ENP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP107832",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP107832",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP107832",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP107832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.