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NICOLLETTE LOUISE BLACK-BALLARD PMHNP
NPI 1083439541
Nurse Practitioner - Psychiatric/Mental Health in Norcross, GA

Active since November 20, 2024PECOS Enrolled
5127 JIMMY CARTER BLVD STE 205, NORCROSS, GA 30093(404) 688-1350 Get Directions Write a Review

NPPES record last updated: January 9, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 9, 2025, Nov 20, 2024 (2 updates tracked since 2024).

About Nicollette Louise Black-ballard Pmhnp NPPES

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

NICOLLETTE LOUISE BLACK-BALLARD PMHNP (NPI 1083439541) is an individual psychiatric/mental health provider in Norcross, Georgia, licensed in Georgia (290443) and active in the NPI registry since November 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083439541
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameNICOLLETTE LOUISE BLACK-BALLARDCredential: PMHNP
Location Address5127 JIMMY CARTER BLVD STE 205Norcross, GA 30093-1619
Mailing Address2915 Ilir Mnr NwAtlanta, GA 30318-2231 · (404) 748-8349
Phone(404) 688-1350
Sole ProprietorNo
Enumeration DateNovember 20, 2024
Last NPPES UpdateJanuary 9, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 9, 2025
✔ NPI 1083439541 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in GA · 290443
5127 JIMMY CARTER BLVD STE 205, Norcross, GA 30093
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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)

Nicollette Louise Black-ballard Pmhnp 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 30093 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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

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

ANGELICA MARIA FORERO NP
Nurse Practitioner (Family)
5127 JIMMY CARTER BLVD STE 205
NORCROSS, GA 30093
Gwinnett County (404) 688-1350

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicollette Black-ballard's NPI number?

The NPI number for Nicollette Black-ballard is 1083439541. It was assigned to this individual provider in the NPPES registry on November 20, 2024.

Where is Nicollette Black-ballard located?

Nicollette Black-ballard practices at 5127 Jimmy Carter Blvd Ste 205, Norcross, GA 30093. The listed phone number is (404) 688-1350.

What is Nicollette Black-ballard's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Nicollette Black-ballard enrolled in Medicare?

Yes. Nicollette Black-ballard is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicollette Black-ballard was last updated on January 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.