Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DESTINY SHANTEE BALLANCE FNP-BC
NPI 1073334959
Nurse Practitioner in Rancho Cucamonga, CA

Q: What is Destiny Ballance's NPI number?

The NPI number for Destiny Ballance is 1073334959. It was assigned to this individual provider in the NPPES registry on October 23, 2024.

Q: What is Destiny Ballance's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Destiny Ballance was last updated on September 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 23, 2024PECOS Enrolled

11175 AZUSA CT STE 110, RANCHO CUCAMONGA, CA 91730(909) 715-9611 Get Directions Write a Review

NPPES record last updated: September 2, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Sep 2, 2026, Aug 4, 2026, Mar 26, 2026 and 1 more (4 updates tracked since 2026).

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About Destiny Shantee Ballance Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DESTINY SHANTEE BALLANCE FNP-BC (NPI 1073334959) is an individual nurse practitioner in Rancho Cucamonga, California, licensed in California (95038680) and active in the NPI registry since October 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073334959

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameDESTINY SHANTEE BALLANCECredential: FNP-BC

Location Address11175 AZUSA CT STE 110Rancho Cucamonga, CA 91730-4933

Mailing Address11175 Azusa Ct Ste 110Rancho Cucamonga, CA 91730-4933

Phone(909) 715-9611

Sole ProprietorYes

Enumeration DateOctober 23, 2024

Last NPPES UpdateSeptember 2, 20264 updates tracked since enumeration

NPPES CertifiedSeptember 2, 2026

✔ NPI 1073334959 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Licenses✔ Licensed in CA · 95038680✔ Licensed in NY · 359569✔ Licensed in WA · AP70114616

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedRegistered NurseTaxonomy 163W00000X · License 95042920 (CA)

11175 AZUSA CT STE 110, Rancho Cucamonga, CA 91730

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Destiny Shantee Ballance Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91730 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

Established Patient

$104.64 typical visit price

range $19.37 – $146.42

Typical copayment $26.16 (range $4.84 – $36.60)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARQUAN THOMAS

Community Health Worker