MRS. AMY V BALLOU (NPI# 1487770137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487770137 |
| Entity Type | Individual |
| Full Name | MRS. AMY V BALLOU |
| Credential | BA |
| Practice Address |
1150 Red John Dr Daytona Beach FL 32124-1016 |
| Practice Telephone | 3862361812 |
| Mailing Telephone | 3862361812 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2012-08-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386712313 | Amy Jean Ballou | Occupational Therapist | 1978 Grand Ave Ste 45, West Des Moines, IA 50265-4217 | 2006-11-30 |
| 1477563419 | Amy Ballou | Nurse Practitioner | 14041 Icot Blvd, Clearwater, FL 33760-3702 | 2006-08-09 |
| 1467719732 | Amy Furmanski Ballou | Nurse Practitioner | 166 Stoneridge Dr, Columbia, SC 29210-8239 | 2012-04-11 |
| Street Address |
1150 RED JOHN DR |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32124-1016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396742490 | Theodore Frank Matejka | Nurse Practitioner | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2005-07-05 |
| 1104464882 | Dane Huge | Nurse Practitioner | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2019-12-13 |
| 1114049715 | Linda Jean Crandall | Counselor | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2007-04-04 |
| 1508983826 | Kathleen Rogan | Counselor | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2007-03-23 |
| 1457476863 | Scott Henry March | Social Worker | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2007-03-21 |
| 1750407110 | Liza M Sampson | Counselor | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2007-03-21 |
| 1912032483 | Colleen Ritchie | Counselor | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2007-02-23 |
| 1497734735 | Leo Salter | Psychologist | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2006-01-14 |
| 1669450466 | Sma Healthcare Inc | Community/Behavioral Health | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2006-01-03 |
| 1376521187 | Sma Healthcare Inc | Community Based Residential Treatment Facility, Mental Illness | 1150 Red John Dr, Daytona Beach, FL 32124-1016 | 2006-01-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407302599 | Christine Lapila | Behavioral Analyst | 201 Thornberg Branch Lane, Daytona Beach, FL 32124 | 2016-08-29 |
| 1194708495 | Brent N. Fulton | Family Medicine | 3127 W International Speedway Blvd., Daytona Beach, FL 32124 | 2005-11-21 |
| 1891212130 | Brian Moore | Early Intervention Provider Agency | 201 Thornberry Branch Ln, Daytona Beach, FL 32124 | 2017-08-28 |
| 1588834725 | Glendoria Stephens | Counselor | 3875 Tiger Bay Rd, Rm 914 Bldg I, Daytona Beach, FL 32124 | 2008-03-04 |
| 1003146887 | Sequel Tsi of Florida, LLC Daytona Transitional | Residential Treatment Facility, Emotionally Disturbed Children | 1386 Indian Lake Rd, Daytona Beach, FL 32124-1001 | 2009-12-30 |
| 1376874370 | Sequel Tsi of Florida, LLC Daytona Residential Treatment Center | Psychiatric Residential Treatment Facility | 1386 Indian Lake Rd, Daytona Beach, FL 32124-1001 | 2010-01-15 |
| 1710531454 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 2630 Lpga Blvd, Daytona Beach, FL 32124-1008 | 2019-07-31 |
| 1336746544 | Kyle Adams | Pharmacist | 2630 Lpga Blvd, Daytona Beach, FL 32124-1008 | 2020-10-01 |
| 1750369666 | Sma Healthcare Inc | Community/Behavioral Health | 1150 Red John Road, Daytona Beach, FL 32124-1016 | 2006-01-03 |
| 1467805465 | Ocean Road LLC | Community/Behavioral Health | 3520 W International Speedway Blvd, Daytona Beach, FL 32124-1026 | 2016-07-14 |
| Find all providers in zip 32124 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477077451 | Sharon Denise Astrologo | Case Manager/Care Coordinator | 421 S. Keech St., Daytona Beach, FL 32164 | 2017-08-01 |
| 1841746658 | Terrell Irvin | Case Manager/Care Coordinator | 240 N. Frederick Ave, Daytona Beach, FL 32114 | 2016-08-31 |
| 1194107821 | Jerusha Thacker | Case Manager/Care Coordinator | 259 Bill France Blvd. Ste 200, Daytona Beach, FL 32174 | 2015-06-18 |
| 1871912329 | Darrell Anthony Shell | Case Manager/Care Coordinator | 435 S Ridgewood Ave # 118, Daytona Beach, FL 32114-4927 | 2014-04-14 |
| 1376971317 | Walter Craig Green Jr. | Case Manager/Care Coordinator | 259 Bill France Blvd. Suite 200, Daytona Beach, FL 32114 | 2013-10-30 |
| 1477806743 | Rhonda Levette Williams | Case Manager/Care Coordinator | 827 Kottle Cir N, Daytona Beach, FL 32114-4720 | 2012-10-23 |
| 1700135308 | Fred Baker | Case Manager/Care Coordinator | 160 N. Beach St., Daytona Beach, FL 32114 | 2012-08-29 |
| 1740538933 | Raegan L Jones | Case Manager/Care Coordinator | 160 North Beach Street, Daytona Beach, FL 32114-3314 | 2012-08-21 |
| 1083980387 | Teresa M Broxton | Case Manager/Care Coordinator | 401 N Ridgewood Avenue, Daytona Beach, FL 32114 | 2012-03-30 |
| 1396971156 | Erica N Simpson | Case Manager/Care Coordinator | 521 Cannon St, Daytona Beach, FL 32114-2503 | 2009-06-08 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32124 |
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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.