STEPHANIE TRENT BALLARD (NPI# 1083037691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083037691 |
| Entity Type | Individual |
| Full Name | STEPHANIE TRENT BALLARD |
| Credential | PHYSICIAN ASSISTANT |
| Practice Address |
2587 Henderson Dr Jacksonville NC 28546-5253 |
| Practice Telephone | 9109383200 |
| Mailing Telephone | 9109383200 |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2020-06-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0010-04664 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1083037691 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871840413 | Stephanie Ann Ballard | Occupational Therapist | 1717 Burke Ave Ne, Grand Rapids, MI 49505-4879 | 2012-08-14 |
| 1699125179 | Stephanie Ballard | Acupuncturist | 3809 S 2nd St, Suite D100, Austin, TX 78704-7036 | 2016-06-15 |
| 1407241771 | Stephanie Ballard | Nurse Practitioner | 3655 Vista Ave, Saint Louis, MO 63110-2539 | 2015-04-02 |
| 1952531568 | Stephanie Lynn Ballard | Pharmacist | 3970 Rca Blvd, Suite 7006, Palm Beach Gardens, FL 33410-4253 | 2009-07-16 |
| Street Address |
2587 HENDERSON DR |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-5253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235143231 | Swetang Patel, Md, Pa | Family Medicine | 2587 Henderson Dr, Jacksonville, NC 28546-5253 | 2006-07-28 |
| 1710365135 | Lauren Ambrose | Physician Assistant | 2587 Henderson Dr, Jacksonville, NC 28546-5253 | 2015-05-18 |
| 1205020476 | Jacksonville Family Medical Center, Pllc | Clinic/Center | 2587 Henderson Dr, Jacksonville, NC 28546-5253 | 2007-08-30 |
| 1518184431 | Cynthia Ann Lamson | Nurse Practitioner | 2587 Henderson Dr, Jacksonville, NC 28546-5253 | 2007-04-20 |
| 1104925056 | Jacksonville Family Medical Center, Pllc | Family Medicine | 2587 Henderson Dr, Jacksonville, NC 28546-5253 | 2006-09-21 |
| 1164436606 | Swetang M Patel | Family Medicine | 2587 Henderson Dr, Jacksonville, NC 28546-5253 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831799527 | Emily Vander Zee | Physician Assistant | 6680 Bennett Creek Dr Apt 213, Jacksonville, FL 32216-0018 | 2020-10-30 |
| 1245830314 | Jonathan V Korah | Physician Assistant | 6650 Corporate Center Pkwy Apt 1108, Jacksonville, FL 32216-8725 | 2020-10-28 |
| 1255931473 | Rachel Gavrielle Stahly | Physician Assistant | 11438 Emuness Rd, Jacksonville, FL 32218-4050 | 2020-10-27 |
| 1760099071 | Laura Alexandra Ramos-heckman | Physician Assistant | 2014 Capistrano Dr, Jacksonville, FL 32224-3091 | 2020-09-30 |
| 1184230583 | Julian Clouse | Physician Assistant | 9803 Creekfront Rd Apt 307, Jacksonville, FL 32256-8449 | 2020-09-21 |
| 1962016717 | Stephanie Benton Gentry | Physician Assistant | 3179 Shadow Creek Rd, Jacksonville, FL 32226-2386 | 2020-08-31 |
| 1629689435 | Monarch Mental Health Association | Physician Assistant | 5393 Roosevelt Blvd Ste 8, Jacksonville, FL 32210-8424 | 2020-08-14 |
| 1235749425 | Nicole Lhommedieu | Physician Assistant | 3850 Marnie Pl, Jacksonville, FL 32223-3541 | 2020-08-03 |
| 1861002123 | Naw-am Acio Daniels | Physician Assistant | 7467 Volley Dr N, Jacksonville, FL 32277-9368 | 2020-08-03 |
| 1750906640 | Veronica Adriana Dediego | Physician Assistant | 915 W Monroe St Ste 300, Jacksonville, FL 32204-1177 | 2020-06-16 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.