M. Janice Ballou, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

529718 Issued in TX

Practice address

5201 Harry Hines Blvd
Medical Staff Services
Dallas, TX 75235-7708

Phone

(214) 590-8006

NPI assigned

Jul 19, 2005

Last updated

Nov 22, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jballou159187@direct.ohsu.edu

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.

• Mid-Columbia Medical Center

  dba Adventist Health Columbia Gorge

  • General Practice Physician
  • The Dalles, OR
  • NPI 1053409599
  Medicare reassignment NPD
• Healthcare for the Mid-Columbia Region

  • Emergency Medicine Physician
  • The Dalles, OR
  • NPI 1497797856
  NPD
• Mid-Columbia Medical Center

  dba Adventist Health Columbia Gorge

  • Rural Health Clinic/Center
  • The Dalles, OR
  • NPI 1154351336
  NPD
• Mid-Columbia Medical Center

  dba Adventist Health Columbia Gorge

  • Multi-Specialty Clinic/Center
  • The Dalles, OR
  • NPI 1366809048
  NPD
• Mid-Columbia Medical Center

  dba Adventist Health Columbia Gorge

  • Multi-Specialty Clinic/Center
  • The Dalles, OR
  • NPI 1992094817
  NPD (past)

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227312000000",
    "number": "1952300105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 HARRY HINES BLVD",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357708",
            "telephone_number": "214-590-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLOU",
        "first_name": "M.",
        "middle_name": "JANICE",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2008-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "529718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063830602",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063830603",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8N4803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Dent Ballard, O.D.
• Kyla Francesca Ballesteros, MD
• Bailey Ballinger, SLP
• Kara Ann Ballinger, CRNA
• Roberto Alejandro Ballivian, M.D.
• Bassam Ali Ballout
• Rami Ballout, MD
• Maynon Michelle Ballow, CLINICAL NUTRITION/B
• Gregory Balogun
• Olayiwade Esther Balogun, RN, MSN, WHNP-BC

• Pediatric Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.