AMANDA L BALLARD (NPI# 1851546667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851546667 |
| Entity Type | Individual |
| Full Name | AMANDA L BALLARD |
| Credential | SAC-IT, OT |
| Practice Address |
2600 Humes Rd Ste 100 Janesville WI 53545 |
| Mailing Address |
2600 Humes Rd Ste 100 Janesville WI 53545-0491 |
| Practice Telephone | 6087412117 |
| Mailing Telephone | 6087412117 |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2020-06-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
18847-130 | WI | Behavioral Health & Social Service Providers |
| N | 225X00000X | Occupational Therapist | 5202-26 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 225X00000X | Occupational Therapist | 056008907 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 225X00000X | Occupational Therapist | 103657 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | ENROLLED | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1401 E State St, Rockford, IL 611042315 | 7794894595 | |
| 200 1st St Sw, Rochester, MN 559050001 | 5072842511 | |
| 4730 Squaw Prairie Rd, Belvidere, IL 610088800 | 8155449495 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801112362 | Amanda Lynn Ballard | Massage Therapist | 5710 Sw Daisy St, Port Orchard, WA 98367-7350 | 2010-04-08 |
| 1164983375 | Amanda Ballard | Physician Assistant | 160 E Artesia St Ste 255, Pomona, CA 91767-2921 | 2019-03-29 |
| 1285969055 | Amanda M Ballard | Optometrist | 325 W Walnut St, Ste400, Lebanon, KY 40033-1377 | 2009-10-12 |
| Street Address |
2600 HUMES RD STE 100 |
| City | JANESVILLE |
| State | WI |
| Zip Code | 53545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376178350 | Monica L. Hinkle | Social Worker | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2020-03-10 |
| 1467082313 | Jacquelyn M. O'flahrity | Social Worker | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2020-01-20 |
| 1972163004 | Danielle R. Ebben | Counselor | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2019-06-20 |
| 1518521186 | Debra K. Westby | Social Worker | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2019-04-29 |
| 1881165991 | Sarah A. Wellnitz | Social Worker | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2018-12-16 |
| 1568986578 | Deborah A. Dubanowich | Counselor | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2017-08-01 |
| 1699143909 | Jessica L Jach | Social Worker | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2015-09-03 |
| 1336529932 | Phillip L. Stall | Psychiatry & Neurology | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2015-06-09 |
| 1194043554 | Rathna Sree Mallela | Psychiatry & Neurology | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2010-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730743816 | Wisteria Lyn Gunnink | Social Worker | 3530 N County Highway F, Janesville, WI 53545 | 2019-04-24 |
| 1730601295 | Selma Mohammedi | Dentist | 1260 Milton Ave Ste 140-150, Janesville, WI 53545 | 2017-07-16 |
| 1205357472 | Andrea Jayne Thompson | Physical Therapist | 3418 N Parker Dr., Janesville, WI 53545 | 2017-06-28 |
| 1639549983 | Sylvia Andrus | Physical Therapy Assistant | 3400 N Country Highway F, Janesville, WI 53545 | 2015-09-30 |
| 1518372564 | Kimberly Ann Bishop | Registered Nurse | 32 E. Racine Street, Suite 150, Janesville, WI 53545 | 2014-06-29 |
| 1679998314 | Quirt Family Dentistry | Dentist | 2201 Humes Road Suite 150, Janesville, WI 53545 | 2014-03-04 |
| 1104163740 | Sarah J Fredricks | Licensed Practical Nurse | 1406 Holiday Drive, Janesville, WI 53545 | 2013-01-15 |
| 1659629335 | Parvin Mesbah | Pharmacist | 2017 Old Humes Road, T-0809, Janesville, WI 53545 | 2012-08-28 |
| 1962797118 | Tiffany Schmidt | Pharmacist | 2017 Humes Road, T-0809, Janesv Ille, WI 53545 | 2011-06-16 |
| 1174817795 | Megan Steiner | Dentist | 1504 Creston Park Drive, Janesville, WI 53545 | 2011-05-31 |
| Find all providers in zip 53545 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700131232 | Tiffany L Strodthoff | Counselor | 15 W Milwaukee St Ste 207, Janesville, WI 53548-2998 | 2012-07-20 |
| 1396018131 | Holli K Tinder | Counselor | 2000 E Racine St Ste 120, Janesville, WI 53545-4300 | 2012-02-09 |
| 1821398736 | Passageway, Inc. Frs-tr | Counselor | 3246 W Rollingwood Dr, Janesville, WI 53545-9030 | 2010-10-25 |
| 1154631679 | Cheryl M Frei | Counselor | 200 S Parker Dr, Janesville, WI 53545-3932 | 2010-10-18 |
| 1376711671 | Kim N Conrad | Counselor | 612 N Randall Ave Ste A, Janesville, WI 53545-1958 | 2008-02-20 |
| 1093992158 | Emma Gene Harrell | Counselor | 203 W Sunny Lane, Janesville, WI 53546 | 2008-01-30 |
| 1265562037 | Kathleen M Miller | Counselor | 3246 W. Rollingwood Drive, Janesville, WI 53545-9030 | 2007-03-07 |
| 1710076914 | William Hollingsworth | Counselor | 2640 Milton Ave, Janesville, WI 53545-0231 | 2006-10-12 |
| 1255348314 | Sam Paul Romano Jr. | Counselor | 612 N Randall Ave, Janesville, WI 53545-1958 | 2006-08-02 |
| 1972163004 | Danielle R. Ebben | Counselor | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2019-06-20 |
| Find all providers in JANESVILLE | ||||
| City | JANESVILLE |
| Zip Code | 53545 |
Please comment or provide details below to improve the information on AMANDA L BALLARD.
| 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.