Jennifer Marie Ballou (NPI# 1518420629, PAC ID# 4688905052) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1518420629 |
| PAC ID by PECOS | 4688905052 |
| Professional Enrollment ID | I20191016001699 |
| Full Name | Jennifer Marie Ballou |
| Organization Legal Name | COOLEY NEUROSURGICAL CLINIC INC |
| Address |
1924 Allentown Rd Lima OH 45805-1849 |
| Phone Number | 4192298928 |
| Gender | F |
| Graduation Year | 2019 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 6406014976 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360066 | ST RITA'S MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1924 Allentown Rd, Lima, OH 45805-1849 | 4192298928 | COOLEY NEUROSURGICAL CLINIC INC |
| Organization Legal Name | COOLEY NEUROSURGICAL CLINIC INC |
| Physicians | 1 |
| Street Address |
1924 ALLENTOWN RD |
| City | LIMA |
| State | OH |
| Zip | 45805-1849 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Darryl M Haycock | Podiatry | 2311 Baton Rouge, Lima, OH 45805-1129 | |
| Mary Shenouda | Ophthalmology | Advanced Vision Care, Inc | 2300 Baton Rouge, Lima, OH 45805-1130 |
| Michael T Craig | Ophthalmology | Advanced Vision Care, Inc | 2300 Baton Rouge, Lima, OH 45805-1130 |
| Michael Griffith | Psychologist, Clinical | 3000 Elida Rd, Suite 2, Lima, OH 45805-1232 | |
| Michael Fishbaugh Jr. | Optometry | Michael A. Fishbaugh Jr. O.d. Inc. | 1301 N Cable Rd, Lima, OH 45805-1407 |
| Amy L Bankey | Optometry | Michael A. Fishbaugh Jr. O.d. Inc. | 1301 N Cable Rd, Lima, OH 45805-1407 |
| Ashley Nicole Schoenherr | Optometry | Michael A. Fishbaugh Jr. O.d. Inc. | 1301 N Cable Rd, Lima, OH 45805-1407 |
| John Gillis | Chiropractic | 1905 Latham Ave, Lima, OH 45805-1637 | |
| Matthew P Ziccardi | Clinical Psychologist | 1045 Mackenzie Dr, Lima, OH 45805-1660 | |
| Omar A Sweidan | Optometry | 2155 Allentown Rd, Lima, OH 45805-1705 | |
| Find all physicians in zip 45805 | |||
| City | LIMA |
| Zip Code | 45805 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | LIMA + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.