Individual provider Active NPI

Patsy Ann Ballard, FNPC

  • Nurse Practitioner
  • Penn Yan, NY
National Provider Identifier
1902969587
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F3318891 Issued in NY
Practice address
418 N Main St
Keuka Health Care
Penn Yan, NY 14527-1070
Phone
(315) 531-2944
Fax
(315) 536-0430
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F3318891 NY Primary

Addresses

Primary practice location

418 N Main St
Keuka Health Care
Penn Yan, NY 14527-1070

Mailing address

2166 Ellis Road
Dundee, NY 14837
Phone (315) 531-2944

Other identifiers 1

IdentifierTypeStateIssuer
02218688MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080729000144 NY Practitioner - Nurse Practitioner 1951475714 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F3318891NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Soldiers & Sailors Memorial Hospital Current Accepting new patients
Finger Lakes Area Counseling and Recovery Agency, Inc. CurrentSince Mar 11, 2021 Accepting new patients
FLH Medical, PC CurrentSince Aug 25, 2009 Accepting new patients
FLH Medical, PC CurrentSince Aug 25, 2009 Accepting new patients

Locations

8000 Box
Buffalo, NY 14267
Phone (716) 213-0772

28 E Main St
Clifton Springs, NY 14432
Phone (315) 462-9466

789 Pre Emption Rd
Geneva, NY 14456
Phone (315) 781-2000

196 North St
Geneva, NY 14456
Phone (315) 787-4156

141 Central Ave
Keuka Park, NY 14478
Phone (315) 279-5000

418 N Main St
Penn Yan, NY 14527
Phone (315) 531-2000

339 East Ave
Ste 303
Rochester, NY 14604
Phone (315) 462-9466

Interoperability endpoints

  • Direct secure messaging: p.ballard@flhmedical.medentdirect.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1902969587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2166 ELLIS ROAD",
            "city": "DUNDEE",
            "state": "NY",
            "postal_code": "14837",
            "telephone_number": "315-531-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 N MAIN ST",
            "address_2": "KEUKA HEALTH CARE",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271070",
            "telephone_number": "315-531-2944",
            "fax_number": "315-536-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "PATSY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F3318891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02218688",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Penn Yan, NY

Sources for this page

Verify at the official NPI Registry.