GARY H BALLARD NP NPI 1720022395

NPI Information

  • NPI: 1720022395
  • Provider Name: GARY H BALLARD, NP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 403 MCBRIEN RD
    EAST RIDGE, TN
    ZIP 37412
  • Phone: (423) 894-3589

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NPI Details

Gary H Ballard, NP is a family nurse practitioner in East Ridge, TN. Gary H Ballard, NP NPI is 1720022395. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

403 MCBRIEN RD
EAST RIDGE, TN
ZIP 37412-223
Phone: (423) 894-3589
Fax: (423) 892-3378

The enumeration date for this NPI number is 6/15/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyRN0000063398TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13904231MEDICARE ID-TYPE UNSPECIFIED
2P39094MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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