NPIMap

Organization Active NPI

Ballinger Clinic, PLLC

  • Family Medicine Physician
  • Mountlake Terrace, WA
National Provider Identifier
1982791349
Registry record updated Oct 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BALLINGER CLINIC, PLLC
Practice address
6007B 244TH St SW
Mountlake Terrace, WA 98043-5400
Phone
(425) 640-4830
Fax
(425) 640-4885
NPI assigned
Oct 6, 2006
Last updated
Oct 31, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2008

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

Authorized official

Name
Rocky William Mazzeo, MDNPI 1487662235
Title
Owner Partner
Phone
(425) 640-4830

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Family Medicine Physician 207Q00000X WA Primary
Internal Medicine Physician 207R00000X WA
Physical Therapist 225100000X WA

Addresses

Primary practice location

6007B 244TH St SW
Mountlake Terrace, WA 98043-5400

Mailing address

6007B 244TH St SW
Mountlake Terrace, WA 98043-5400
Phone (425) 640-4830

Other identifiers 1

IdentifierTypeStateIssuer
7073596MedicaidWA

National Provider Directory

National Provider Directory

Locations

6007 244th St SW
#B
Mountlake Terrace, WA 98043
Phone (425) 640-4830

6007 244th St SW
Ste B
Mountlake Terrace, WA 98043
Phone (425) 640-4762

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225411200000",
    "number": "1982791349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6007B 244TH ST SW",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980435400",
            "telephone_number": "425-640-4830",
            "fax_number": "425-640-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6007B 244TH ST SW",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980435400",
            "telephone_number": "425-640-4830",
            "fax_number": "425-640-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALLINGER CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2008-10-31",
        "status": "A",
        "authorized_official_last_name": "MAZZEO",
        "authorized_official_first_name": "ROCKY",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER  PARTNER",
        "authorized_official_telephone_number": "425-640-4830",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7073596",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountlake Terrace, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.