DR. JEFFREY DAVID BALLER (NPI# 1710981519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710981519 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY DAVID BALLER |
| Credential | D.P.M. |
| Practice Address |
2600 Kanell Blvd Poplar Bluff MO 63901-3001 |
| Practice Telephone | 5737854546 |
| Practice Fax Number | 5737856959 |
| Mailing Telephone | 5737854546 |
| Mailing Fax Number | 5737856959 |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2019-08-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
2009020599 | MO | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1710981519 | 05 |
| Street Address |
2600 KANELL BLVD |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-3001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144283524 | Clint Vanlandingham | Durable Medical Equipment & Medical Supplies | 2600 Kanell Blvd, Poplar Bluff, MO 63901-3001 | 2006-04-07 |
| 1508838566 | Clint L Vanlandingham | Podiatrist | 2600 Kanell Blvd, Poplar Bluff, MO 63901-3001 | 2006-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1285271239 | Front Door Wellness LLC | Physical Therapist | Front Door Wellness LLC, 5835 Quail Meadows Drive, Poplar Bluff, MO 63901 | 2019-12-09 |
| 1104470368 | Andrew Akindutire | Dentist | 3101 Oak Groove Rd., Suite 6, Poplar Bluff, MO 63901 | 2019-07-26 |
| 1780195966 | Midwest Equipment Srv Systems LLC | Technician, Pathology | 2400 Lucy Lee Parkway, Suite C, Poplar Bluff, MO 63901 | 2017-10-16 |
| 1801259387 | Richard Justin Huber | Technician, Other | 3005 Warrior Ln, Poplar Bluff, MO 63901 | 2016-04-01 |
| 1699136275 | Donja Kirkland | Recreation Therapist | 1910a Greenwood Dr., Suite D, Poplar Bluff, MO 63901 | 2016-03-10 |
| 1760866867 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 3050 Tucker Road, Poplar Bluff, MO 63901 | 2015-07-17 |
| 1407246390 | Lisa Marie Payne | Physical Therapist | 4358c Highway Pp, Poplar Bluff, MO 63901 | 2015-01-29 |
| 1700202488 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1602 W. Harper Street, Poplar Bluff, MO 63901 | 2014-03-05 |
| 1932521648 | Essential Family Healthcare, LLC | Clinic/Center | 1369 North Westwood Blvd., Poplar Bluff, MO 63901 | 2014-01-15 |
| Find all providers in zip 63901 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710305677 | Kevin M Renner | Podiatrist | 225 Physicians Park Ste 102, Poplar Bluff, MO 63901-3918 | 2014-03-28 |
| 1366853715 | Abigail Smith | Podiatrist | 225 Physicians Park Ste 102, Poplar Bluff, MO 63901 | 2014-05-19 |
| 1528023934 | Zackwrie S Parr | Podiatrist | 2002 Kanell Blvd, Suite 201, Poplar Bluff, MO 63901-4045 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851923023 | Center for Advanced Foot & Ankle Surgery, Inc. | Podiatrist | 3915 Watson Rd Ste 200, Saint Louis, MO 63109-1251 | 2020-02-06 |
| 1518486885 | Sunflower Podiatry and Wellness | Podiatrist | 1316 Hebert Street, Saint Louis, MO 63107 | 2017-09-18 |
| 1144753492 | Creighton Woolsey | Podiatrist | 1155 W Parkview St Ste 2j, Bolivar, MO 65613-8598 | 2017-04-04 |
| 1457701559 | Robert Austin Djali | Podiatrist | 1224 Graham Rd Ste 3010, Florissant, MO 63031-8028 | 2016-06-20 |
| 1770978074 | Shelly Diane Sedberry | Podiatrist | 1801 W 32nd St Bldg C, Joplin, MO 64804 | 2015-04-02 |
| 1376936591 | Corey Bess | Podiatrist | 1010 Carondelet Dr Ste 301, Kansas City, MO 64114 | 2015-03-12 |
| 1093117335 | True Health Integration and Synergy | Podiatrist | 6311 Ronald Reagan Dr, #167, Lake St Louis, MO 63367-2681 | 2014-09-18 |
| 1134474554 | Rajan K Patel | Podiatrist | 3930 S Jackson Dr, Apt 308, Independence, MO 64057-1706 | 2012-07-23 |
| 1720346307 | Feet for Life Centers Inc PC | Podiatrist | 17201 Chesterfield Airport Rd, Chesterfield, MO 63005-1423 | 2012-05-02 |
| 1669745501 | West County Foot and Ankle LLC | Podiatrist | 10004 Kennerly Rd Ste 300a, Saint Louis, MO 63128 | 2012-02-22 |
| Find all providers with the same taxonomy | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
Please comment or provide details below to improve the information on DR. JEFFREY DAVID BALLER.
| 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.