DR. RICHARD DANE BALLARD (NPI# 1366739054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366739054 |
Entity Type | Individual |
Full Name | DR. RICHARD DANE BALLARD |
Credential | M.D. |
Practice Address |
499 Gloster Creek Vlg Ste A2 Tupelo MS 38801 |
Mailing Address |
499 Gloster Creek Vlg Ste A2 Tupelo MS 38801-4749 |
Practice Telephone | 6626206800 |
Practice Fax Number | 6626206950 |
Mailing Telephone | 6626206800 |
Mailing Fax Number | 6626206950 |
Enumeration Date | 2011-07-01 |
Last Update Date | 2018-09-18 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
22430 | MS | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | 05300066 | 05 | |
MS | TEMPORARY MS MEDICAL LICENSE | T-2401 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
499 Gloster Creek Vlg Ste A2, Tupelo, MS 38801 | 6626206800 | 6626206950 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427542000 | Richard Earl Ballard Jr. | Counselor | Site Office: Charles Carroll Ms 6130 Lamont Drive, C/o Ms. Claudia B.-walter, Fbcog- Ceo for Son Rise Cc&i, New Carrollton, MD 20784 | 2018-06-18 |
1831533447 | Richard G Ballard | Counselor | 3710 Augusta Rd, C/o Our Lady of The Rosary Church, Greenville, SC 29605-1335 | 2013-04-25 |
1740513332 | Richard Newman Ballard | Counselor | 3011 Lexington Rd, Louisville, KY 40206-3005 | 2009-09-14 |
1861523532 | Richard W. Ballard | Dentist | 1002 Girod St, Mandeville, LA 70448-3720 | 2007-03-07 |
1528122397 | Richard Alan Ballard | Optometrist | 690 Old Hickory Blvd, Ste 101, Brentwood, TN 37027-5460 | 2006-12-19 |
1730275975 | Richard Blakeslee Ballard | Dentist | 716 Superior Ave, Gladstone, MI 49837-1751 | 2006-10-05 |
1578662375 | Richard A. Ballard | Dentist | 1221 Michigan St, Sandpoint, ID 83864-1745 | 2006-09-21 |
1033143938 | Richard Douglas Ballard | Chiropractor | 2312 Knob Creek Rd., Ste 204, Johnson City, TN 37604 | 2006-07-10 |
1053554543 | Richard M Ballard Jr. | Social Worker | 2301 Hampton Ave, Saint Louis, MO 63139-2908 | 2009-04-13 |
1073583613 | Richard Ballard | Orthopaedic Surgery | 1200 S Farmerville St, Ruston, LA 71270-5941 | 2006-01-25 |
Street Address |
499 GLOSTER CREEK VLG STE A2 |
City | TUPELO |
State | MS |
Zip Code | 38801 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619919511 | Karl J. Crossen | Internal Medicine | 499 Gloster Creek Vlg Ste A2, Cardiology Associates of North Ms, Tupelo, MS 38801-4749 | 2006-06-12 |
1538769161 | William Todd Sandroni | Pharmacist | 499 Gloster Creek Vlg Ste A2, Tupelo, MS 38801-4749 | 2020-11-01 |
1073157715 | Brandon Heath Petty | Nurse Practitioner | 499 Gloster Creek Vlg Ste A2, Tupelo, MS 38801-4749 | 2019-11-06 |
1023305687 | Michael Ted Boler Jr. | Internal Medicine | 499 Gloster Creek Vlg Ste A2, Tupelo, MS 38801-4749 | 2011-07-05 |
1760797781 | Karthik Venkatesh Prasad | Internal Medicine | 499 Gloster Creek Vlg Ste A2, Tupelo, MS 38801-4749 | 2010-08-13 |
1619174299 | Gwendolyn H Hill | Nurse Practitioner | 499 Gloster Creek Vlg Ste A2, Tupelo, MS 38801-4749 | 2007-06-28 |
1013114677 | Wanda Ikeda | Nurse Practitioner | 499 Gloster Creek Vlg Ste A2, Tupelo, MS 38801-4749 | 2007-06-28 |
1265640148 | Amit Gupta | Internal Medicine | 499 Gloster Creek Vlg Ste A2, Cardiology Associates of North Mississippi, Tupelo, MS 38801-4749 | 2007-05-21 |
1225190382 | Christopher M. Bell | Nurse Practitioner | 499 Gloster Creek Vlg Ste A2, Cardiology Associates of North Ms, Pa, Tupelo, MS 38801-4749 | 2006-12-15 |
1902971492 | Cardiology Associates of North Ms Pa | Internal Medicine | 499 Gloster Creek Vlg Ste A2, Tupelo, MS 38801-4749 | 2006-11-21 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
1821556838 | Wilco Healthcare of North Mississippi, Pllc | Point of Service | 1514 Co Rd 41, Tupelo, MS 38801 | 2019-03-08 |
1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
1073092326 | Lauren Parrish | Nurse Practitioner | 1573 Medical Park Circle, Tupelo, MS 38801 | 2018-08-08 |
1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
1043700933 | Hooks Diabetes & Medicine Clinic | Non-Pharmacy Dispensing Site | 2610 Traceland Drive, Ste A, Tupelo, MS 38801 | 2018-05-16 |
1073035903 | Annette C Riddle | Counselor | 1004 Eisenhower Drive, Tupelo, MS 38801 | 2017-07-12 |
1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
1073975611 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 1168 Cross Creek Drive, Tupelo, MS 38801 | 2016-03-23 |
Find all providers in zip 38801 |
Taxonomy Code | 207RI0011X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Interventional Cardiology |
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134761786 | Cardiovascular Health Center Pllc | Internal Medicine | 4211 Hospital St Ste 202, Pascagoula, MS 39581-5310 | 2019-10-16 |
1497224174 | Fusion Vascular, LLC | Internal Medicine | 800 Pearman Ave, Cleveland, MS 38732-3502 | 2018-11-25 |
1679730329 | Foluso A Fakorede | Internal Medicine | 800 N Pearman Ave, Cleveland, MS 38732-3502 | 2008-05-20 |
1073617775 | Jimmy Darrell Sneed | Internal Medicine | 391 Southcrest Cir Ste 200, Southaven, MS 38671-6729 | 2006-09-12 |
1245214196 | Hemraj R. Makwana | Internal Medicine | 520 Willowbrook Rd, Columbus, MS 39705-2015 | 2005-12-05 |
1720087257 | Joon K Chang | Internal Medicine | 255 Baptist Blvd, Ste. 401, Columbus, MS 39705-2011 | 2005-07-18 |
1154989689 | King and Associates Cardiology Pllc | Internal Medicine | 2323 5th St N, Columbus, MS 39705-2213 | 2019-05-30 |
1053873133 | Cms Care of Ms, LLC | Internal Medicine | 460 Briarwood Dr Ste 400, Jackson, MS 39206-3062 | 2019-04-05 |
1760975692 | Fusion Vascular Center, LLC | Internal Medicine | 800 Pearman Ave, Cleveland, MS 38732 | 2018-06-14 |
1356712848 | Cardiovascular Solutions of Central Ms Pa | Internal Medicine | 800 N Pearman Ave, Cleveland, MS 38732-3502 | 2015-10-09 |
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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.