MATTHEW T. BALLO (NPI# 1013017094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013017094 |
| Entity Type | Individual |
| Full Name | MATTHEW T. BALLO |
| Credential | M.D. |
| Practice Address |
100 N Humphreys Blvd Memphis TN 38120-2146 |
| Practice Telephone | 9016830055 |
| Practice Fax Number | 9016852969 |
| Mailing Telephone | 9016830055 |
| Mailing Fax Number | 9016852969 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2013-12-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
50791 | TN | Allopathic & Osteopathic Physicians |
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
L0014 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 45529701 | 05 |
| Street Address |
100 N HUMPHREYS BLVD |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38120-2146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659375392 | Stephen A Besh | Internal Medicine | 100 N Humphreys Blvd, Memphis, TN 38120-2146 | 2005-06-10 |
| 1548889009 | Danielle Rose Haba | Physical Therapist | 100 N Humphreys Blvd, Memphis, TN 38120-2146 | 2020-04-14 |
| 1255950705 | Jennifer Jacobson | Occupational Therapist | 100 N Humphreys Blvd, Memphis, TN 38120-2146 | 2020-04-14 |
| 1083233621 | Janet Grillis | Clinic/Center | 100 N Humphreys Blvd, Memphis, TN 38120-2146 | 2020-04-14 |
| 1679192207 | Morgan Henry | Occupational Therapist | 100 N Humphreys Blvd, Memphis, TN 38120-2146 | 2020-04-14 |
| 1417576083 | Ashland Shalon Johnson | Speech-Language Pathologist | 100 N Humphreys Blvd, Memphis, TN 38120-2146 | 2020-04-13 |
| 1134748700 | Lakesha Churn | Occupational Therapist | 100 N Humphreys Blvd, Memphis, TN 38120-2146 | 2020-04-13 |
| 1164041745 | Barbara Lynn Spence | Occupational Therapist | 100 N Humphreys Blvd, Memphis, TN 38120-2146 | 2020-04-13 |
| 1578114799 | Sonia Waites | Physical Therapist | 100 N Humphreys Blvd, Memphis, TN 38120-2146 | 2019-09-28 |
| 1700362456 | Katelyn Gayle Tansey | Occupational Therapist | 100 N Humphreys Blvd, Memphis, TN 38120-2146 | 2018-07-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093285637 | Cobblestone Midwifery | Midwife | 5617 Ashley Square South, Memphis, TN 38120 | 2018-11-27 |
| 1649768870 | River City Neuropsychology, Pllc | Psychologist | 1661 International Dr., Suite 400, Memphis, TN 38120 | 2018-04-24 |
| 1841676152 | Jody Lavaun Clements | Dentist | 795 Ridge Lake Blvd Ste 101, Memphis, TN 38120 | 2015-08-10 |
| 1578957122 | Christina Lumpkin | Nurse Practitioner | 6305 Humphreys Blvd Ste 101, Memphis, TN 38120 | 2015-03-21 |
| 1316352099 | Daniel Poor | Emergency Medicine | Baptist Memorial Hospital Memphis, 124 N. Humphrey's Blvd, Memphis, TN 38120 | 2014-06-21 |
| 1245643246 | Kysha Saleem | Nurse Practitioner | 6027 Walnut Grove Rd., Suite 312, Memphis, TN 38120 | 2014-06-06 |
| 1376962613 | John Christopher Swearingen | Dentist | 780 Ridge Lake Blvd Ste 101, Memphis, TN 38120 | 2014-04-15 |
| 1275884645 | Rebecca Leigh Goedecke | Nurse Practitioner | 6215 Humphreys Blvd Ste 301, Memphis, TN 38120 | 2012-09-26 |
| 1730475179 | Sarah Elizabeth Hammond | Surgery | Plastic Surgery Group, 80 Humphreys Blvd #100, Memphis, TN 38120 | 2011-06-23 |
| 1922302785 | Daniel L Hester | Nurse Anesthetist, Certified Registered | 1755 Kirby Parkway Suite 330, Memphis, TN 38120 | 2011-01-07 |
| Find all providers in zip 38120 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801071451 | West Clinic, PC | Radiology | 55 Humphreys Ctr, Suite 100, Memphis, TN 38120-2374 | 2008-01-02 |
| 1518960392 | Thomas E Merchant | Radiology | 262 Danny Thomas Pl # Ms 0515, Memphis, TN 38105-3678 | 2005-05-24 |
| 1942627559 | West Clinic, P.C. | Radiology | 1265 Union Ave, Thomas Basement, Memphis, TN 38104-3415 | 2014-03-20 |
| 1144573999 | Mid-south Medical Professionals, P.a. | Radiology | 6019 Walnut Grove Rd, Memphis, TN 38120-2113 | 2012-10-17 |
| 1639436603 | Sahaja Acharya | Radiology | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2012-04-16 |
| 1902127269 | John Thomas Lucas | Radiology | 262 Danny Thomas Pl, Memphis, TN 38105 | 2010-06-21 |
| 1366769069 | Christopher Lon Tinkle | Radiology | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2010-04-21 |
| 1396941449 | Angela H Wortham | Radiology | 6019 Walnut Grove Road, Memphis, TN 38120 | 2007-06-25 |
| 1932322989 | David Perry Roberge | Radiology | 332 N Lauderdale St, Memphis, TN 38105-2729 | 2007-04-10 |
| 1073616504 | Jea Youl Lee | Radiology | 55 Humphreys Ctr, Suite 100, Memphis, TN 38120-2374 | 2006-09-07 |
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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.