| Carl Andrew Ballard, FNP-C | |
|
2635 Johnson Bottom Rd, Detroit, AL 35552-2731 | |
| (205) 495-0545 | |
| Not Available |
| Full Name | Carl Andrew Ballard |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 5 Years |
| Location | 2635 Johnson Bottom Rd, Detroit, Alabama |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386243574 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 904235 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| North Mississippi Medical Center | Tupelo, MS | Hospital |
| Och Regional Medical Center | Starkville, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| North Mississippi Medical Center, Inc. | 9931010600 | 298 |
| Entity Name | North Mississippi Medical Center, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972608347 PECOS PAC ID: 9931010600 Enrollment ID: O20040413000541 |
| Entity Name | Caretime Medical Clinic, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700247855 PECOS PAC ID: 4587953096 Enrollment ID: O20160523000504 |
| Entity Name | Mid-south Home Care Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346935129 PECOS PAC ID: 4385961093 Enrollment ID: O20230614002849 |
| Mailing Address | Practice Location Address |
|---|---|
| Carl Andrew Ballard, FNP-C 2635 Johnson Bottom Rd, Detroit, AL 35552-2731 Ph: () - | Carl Andrew Ballard, FNP-C 2635 Johnson Bottom Rd, Detroit, AL 35552-2731 Ph: (205) 495-0545 |
Mrs. Terena S Stidham, CFNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 65345 Hwy 17, Detroit, AL 35552 Phone: 205-273-4056 Fax: 205-273-4058 |