Active NPI
Robert Eugene Ballard, O.D.
- Optometrist
- Long Beach, CA
National Provider Identifier
1912919648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5130T
- Practice address
- 37 Long Beach Blvd
Long Beach, CA 90802-4804 - Phone
- (562) 435-6219
- Fax
- (562) 432-6957
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5130T | CA | Primary |
Addresses
Primary practice location
37 Long Beach Blvd
Long Beach, CA 90802-4804
Mailing address
645 Pacific Ave
205
Long Beach, CA 90802-1322
Phone (562) 437-6026
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5130T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brinley & Morad Optometry, Inc | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Optometrist
- Long Beach, CA
- NPI 1144233073
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912919648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "645 PACIFIC AVE",
"address_2": "205",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908021322",
"telephone_number": "562-437-6026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37 LONG BEACH BLVD",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908024804",
"telephone_number": "562-435-6219",
"fax_number": "562-432-6957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLARD",
"first_name": "ROBERT",
"middle_name": "EUGENE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "5130T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.