Kelly Ballou (NPI# 1366467805, PAC ID# 5496658528) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
Nation Provider ID (NPI) | 1366467805 |
PAC ID by PECOS | 5496658528 |
Professional Enrollment ID | I20160119001431 |
Full Name | Kelly Ballou |
Organization Legal Name | DESTINATION DERMATOLOGY LLC |
Address |
60 Main St H Renew Dermatology Frisco CO 80443 |
Phone Number | 3092871909 |
Gender | F |
Credential | PA |
Graduation Year | 2003 |
Primary Specialty | PHYSICIAN ASSISTANT |
Group Practice PAC ID | 5991076374 |
Number of Group Practice Members | 2 |
Accepts Medicare Assignment | Y |
Address | Phone | Organization |
---|---|---|
60 Main St H, Renew Dermatology, Frisco, CO 80443 | 3092871909 | DESTINATION DERMATOLOGY LLC |
Organization Legal Name | DESTINATION DERMATOLOGY LLC |
Physicians | 1 |
Street Address |
60 MAIN ST H RENEW DERMATOLOGY |
City | FRISCO |
State | CO |
Zip | 80443 |
Name | Specialty | Organization | Address |
---|---|---|---|
Paul H Cook Jr. | Optometry | 620 Main St B, Frisco, CO 80443 | |
Jonathan Adam Sherman | Cardiovascular Disease (cardiology) | Vvmc Diversified Services | 323 W Main St, Suite 101, Frisco, CO 80443 |
Sally K Agnoletto | Certified Registered Nurse Anesthetist (crna) | 842 Summit Blvd, Suite 15, Frisco, CO 80443 | |
Jennifer V Gotantas | Physical Therapy | Axis Sports Medicine LLC | 710 N Summit Blvd, Suite 103, Frisco, CO 80443 |
Amy L. Robillard | Nurse Practitioner | Summit Community Care Clinic, Inc. | 360 Peak One Dr, Suite 100, Frisco, CO 80443 |
Chad Alan Ford | Physician Assistant | Vail Summit Orthopaedics | 360 Peak One Dr, Suite 180, Frisco, CO 80443 |
Annie Bowen | Physician Assistant | Vail Summit Orthopaedics | 360 Peak One Dr, Suite 180, Frisco, CO 80443 |
Scott E Raub | Physical Medicine and Rehabilitation | Vail Summit Orthopaedics | 360 Peak One Dr, Suite 180, Frisco, CO 80443 |
Eleanor Lacy Bruin | Clinical Social Worker | Catholic Health Initiatives Colorado | 360 Peak One Dr, 300 Centura Health Physician Group High Country Health, Frisco, CO 80443 |
Colleen D. Ihnken | Nurse Practitioner | Summit Community Care Clinic, Inc. | 360 Peak One Dr, Suite 100, Frisco, CO 80443 |
Find all physicians in zip 80443 |
City | FRISCO |
Zip Code | 80443 |
Specialty | PHYSICIAN ASSISTANT |
City + Specialty | FRISCO + PHYSICIAN ASSISTANT |
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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.