MR. RANDY ALLAN BALLARD (NPI# 1710375712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710375712 |
| Entity Type | Individual |
| Full Name | MR. RANDY ALLAN BALLARD |
| Credential | ATC |
| Practice Address |
3112 Valerie Dr Champaign IL 61822-1831 |
| Practice Telephone | 2177668137 |
| Mailing Telephone | 2177668137 |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2014-12-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
096.001564 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3112 VALERIE DR |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61822-1831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083180830 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 2718 N Prospect Avenue, Champaign, IL 61822 | 2018-10-19 |
| 1487129730 | Siegfred T. Celis | Occupational Therapy Assistant | 1820 Oak Park Drive, Champaign, IL 61822 | 2018-10-12 |
| 1134633746 | Osf Healthcare System | Home Health | 1501 Interstate Dr Ste C, Champaign, IL 61822 | 2017-11-20 |
| 1386164200 | Carlo Sandico | Physical Therapist | 612 Corey Lane, Champagne, IL 61822 | 2017-06-21 |
| 1295270288 | Jennifer Lee Lugo | Registered Nurse | 3101 Fields South Dr., Champaign, IL 61822 | 2016-12-29 |
| 1902341209 | Jala Simmons | Behavioral Analyst | 4112 Fieldstone Rd, Suite B, Champaign, IL 61822 | 2016-12-22 |
| 1639552433 | Muhammad Ajmal | Internal Medicine | 1701 Curtis Road, Carle Clinic, Champaign, IL 61822 | 2015-06-30 |
| 1518363761 | Margaret A. Hallden | Hearing Instrument Specialist | 3354 Big Pine Trail #c, Audibel Hearing Aids, Champaign, IL 61822 | 2014-11-17 |
| 1801291638 | Kristen Karlsen | Pharmacist | 3114 Village Office Place, Champaign, IL 61822 | 2014-10-22 |
| 1649601543 | Jeff Chu | Optometrist | 507 W. Town Center Blvd, Champaign, IL 61822 | 2013-12-03 |
| Find all providers in zip 61822 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437778412 | Robert Francis Macfarlane IIi | Specialist/Technologist | 3105 Palmer Dr, Champaign, IL 61822-1366 | 2020-04-10 |
| 1376181602 | Karianne J Gardner | Specialist/Technologist | 4702 Vahalla Dr, Champaign, IL 61822-3334 | 2019-12-17 |
| 1831735851 | Connor Patrick Doherty | Specialist/Technologist | 1207 S Oak St # Mc-574, Champaign, IL 61820-6901 | 2019-11-25 |
| 1063991248 | Haley Holz | Specialist/Technologist | 1700 S 4th St, Champaign, IL 61820-6941 | 2018-08-09 |
| 1578071296 | Brady Baker | Specialist/Technologist | 1206 S 4th St, Champaign, IL 61820-6953 | 2018-01-16 |
| 1346759586 | Autumn Nicole Taylor | Specialist/Technologist | 1750 S 4th St, Champaign, IL 61820-6948 | 2017-09-20 |
| 1972059418 | Rebecca Lynn Kaefring | Specialist/Technologist | 4611 Brittany Trail Dr, Champaign, IL 61822-3547 | 2016-08-25 |
| 1932507779 | Kevin Moehn | Specialist/Technologist | 622 W Clark St Apt 3, Champaign, IL 61820-4665 | 2014-12-10 |
| 1669877866 | Shanti Calabrese | Specialist/Technologist | 302 Hessel Blvd, Champaign, IL 61820-6416 | 2014-10-30 |
| 1578967303 | Meaghan Naas | Specialist/Technologist | 605 Teal Cv, Champaign, IL 61821-3544 | 2014-10-22 |
| Find all providers in CHAMPAIGN | ||||
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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.