NPIMap

Individual provider Active NPI

Shannon Ballard, PA-C

  • Medical Physician Assistant
  • Newcastle, WY
National Provider Identifier
1962723130
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1124 Washington Blvd
Newcastle, WY 82701-2972
Phone
(307) 746-3700
NPI assigned
Jun 22, 2010
Last updated
Dec 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

1124 Washington Blvd
Newcastle, WY 82701-2972

Mailing address

2801 Purcell St
Brighton, CO 80601-3551
Phone (303) 659-9700

Other practice location 1

921 Ballancee Ave
Lusk, WY 82225-5245
Phone (720) 316-6903

Other identifiers 1

IdentifierTypeStateIssuer
294465YN7QOtherCOMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190614001541 WY Practitioner - Physician Assistant 4486895422 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weston County Hospital DistrictGroup PAC ID 0042293276, 12 clinicians
Niobrara County Hospital DistrictGroup PAC ID 7012938780, 7 clinicians

Practice addresses (Care Compare)

1124 Washington Blvd
Newcastle, WY 82701-2972
Phone (307) 746-4491

921 Ballancee Ave
Lusk, WY 82225-5245
Phone (307) 334-4000

PO Box
Suite 780
Lusk, WY 82225-0780

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Weston County Hospital District CurrentSince Sep 1, 2025 Accepting new patients
Banner Health Physicians West LLC CurrentSince May 11, 2022 Accepting new patients
Community Hospital CurrentSince Jul 1, 2019 Accepting new patients
Community Hospital CurrentSince Jul 1, 2019 Accepting new patients
Weston County Hospital District CurrentSince Dec 1, 2022 Accepting new patients
Advanced Urgent Care LLC Past Accepting new patients

Locations

1124 Washington Blvd
Newcastle, WY 82701
Phone (307) 746-3715

625 Albany Ave
Torrington, WY 82240
Phone (307) 347-8801

1106 Big Horn Ave
Worland, WY 82401
Phone (307) 347-3221

Interoperability endpoints

  • Direct secure messaging: shannon.ballard.1@14719.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1962723130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 PURCELL ST",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806013551",
            "telephone_number": "303-659-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 WASHINGTON BLVD",
            "city": "NEWCASTLE",
            "state": "WY",
            "postal_code": "827012972",
            "telephone_number": "307-746-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 Ballancee Ave",
            "address_purpose": "LOCATION",
            "city": "Lusk",
            "state": "WY",
            "postal_code": "822255245",
            "country_code": "US",
            "telephone_number": "720-316-6903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALLARD",
        "first_name": "SHANNON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "294465YN7Q",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newcastle, WY

Sources for this page

Verify at the official NPI Registry.