KEVIN M. BALLARD P.A.
NPI 1225317365
Physician Assistant in Marietta, GA

NPI Status: Active since August 08, 2011

Contact Information

790 CHURCH ST NE
SUITE 400
MARIETTA, GA
ZIP 30060
Phone: (770) 952-8899

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  • Individual
  • Male
  • Years of Experience 15
  • Physician Assistant
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About KEVIN BALLARD

This page provides the complete NPI Profile along with additional information for Kevin Ballard, a primary care provider established in Marietta, Georgia with a medical specialization in Physician Assistant and more than 15 years of experience. The healthcare provider is registered in the NPI registry with number 1225317365 assigned on August 2011. The practitioner's primary taxonomy code is 363A00000X with license number 006171 (GA). The provider is registered as an individual and his NPI record was last updated 9 years ago.

NPI
1225317365
Provider Name
KEVIN M. BALLARD P.A.
Gender
Male
Entity Type
Individual
Location Address
790 CHURCH ST NE SUITE 400 MARIETTA, GA 30060
Location Phone
(770) 952-8899
Mailing Address
PO BOX 3157 INDIANAPOLIS, IN 46206
Mailing Phone
(855) 871-1526
Medical School Name
OTHER
Graduation Year
2011
Is Sole Proprietor?
No
Enumeration Date
08-08-2011
Last Update Date
03-10-2017
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A primary care provider (PCP) like Kevin Ballard sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
006171
License State
GA
Taxonomy Description
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
003112208AMEDICAID (05)GA 
202I974653MEDICARE PIN (08)GA 
003112208BMEDICAID (05)GA 

Medicare Participation & PECOS Enrollment Status

Kevin Ballard is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Kevin Ballard is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 6507036050

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20110819000361

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Drainage of fluid from abdominal cavity using imaging guidance

This procedure involves removing excess fluid from your abdominal cavity, which can relieve discomfort. A specialist uses imaging technology to guide a thin needle into the right spot. The fluid is then drained out safely.

This service was performed 18 times for 12 patients

Fluoroscopic guidance for insertion or removal of central vein access device

Fluoroscopic guidance for central vein access device insertion or removal is a procedure where a special X-ray, called a fluoroscope, is used to help accurately place or remove a device in a central vein. This device aids in delivering medications or collecting blood samples.

This service was performed 11 times for 11 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 11 times for 11 patients

Telephone medical discussion with physician, 5-10 minutes

A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.

This service was performed 11 times for 11 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $22.01 for a new patient copayment and $17.71 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 30060 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $88.06
  • Minimum New Patient Price $56.84
  • Maximum New Patient Price $172.43
  • Average New Patient Copayment $22.01
  • Minimum New Patient Copayment $14.21
  • Maximum New Patient Copayment $43.1

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $70.85
  • Minimum Established Patient Price $18.22
  • Maximum Established Patient Price $140.4
  • Average Established Patient Copayment $17.71
  • Minimum Established Patient Copayment $4.55
  • Maximum Established Patient Copayment $35.1

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Kevin Ballard is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
WELLSTAR KENNESTONE REGIONAL MEDICAL CENTER677 CHURCH STREET
MARIETTA, GA 30060
(770) 793-5000Acute Care Hospitals
WELLSTAR PAULDING MEDICAL CENTER2518 JIMMY LEE SMITH PARKWAY
HIRAM, GA 30141
(470) 644-7000Acute Care Hospitals
WELLSTAR COBB MEDICAL CENTER3950 AUSTELL RD
AUSTELL, GA 30106
(770) 732-4000Acute Care Hospitals
WELLSTAR DOUGLAS MEDICAL CENTER8954 HOSPITAL DRIVE
DOUGLASVILLE, GA 30134
(770) 949-1500Acute Care Hospitals

Reviews for KEVIN M. BALLARD P.A.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1225317365, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
2
Doubled → 4
Pos 4
5
Unchanged
Pos 5
3
Doubled → 6
Pos 6
1
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
3
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 3 → 6 7 → 14 → 5 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 4 + 5 + 6 + 1 + 1 + 4 + 3 + 1 + 2 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1225317365.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Otolaryngology
790 CHURCH ST NE, STE 140
MARIETTA, GA 30060
Internal Medicine
790 CHURCH ST NE, SUITE 230
MARIETTA, GA 30060
Internal Medicine
790 CHURCH ST NE, SUITE 230
MARIETTA, GA 30060
Nurse Practitioner
790 CHURCH ST NE, SUITE 250
MARIETTA, GA 30060
Surgery (Vascular Surgery)
790 CHURCH ST NE, SUITE 570
MARIETTA, GA 30060
Internal Medicine
790 CHURCH ST NE, SUITE 250
MARIETTA, GA 30060
Internal Medicine
790 CHURCH ST NE, SUITE 250
MARIETTA, GA 30060
Surgery
790 CHURCH ST NE, SUITE 570
MARIETTA, GA 30060
Specialist
790 CHURCH ST NE, STE 325
MARIETTA, GA 30060
Pain Medicine (Interventional Pain Medicine)
790 CHURCH ST NE, SUITE 550
MARIETTA, GA 30060
Specialist
790 CHURCH ST NE, SUITE 390
MARIETTA, GA 30060
Clinic/Center (Sleep Disorder Diagnostic)
790 CHURCH ST NE, SUITE 120
MARIETTA, GA 30060
Pharmacist
790 CHURCH ST NE, SUITE 170
MARIETTA, GA 30060
Nurse Practitioner (Women's Health)
790 CHURCH ST NE, SUITE 410
MARIETTA, GA 30060
Pharmacist
790 CHURCH ST NE, SUITE 170
MARIETTA, GA 30060
Specialist
790 CHURCH ST NE, SUITE 410
MARIETTA, GA 30060
Internal Medicine
790 CHURCH ST NE, STE 325
MARIETTA, GA 30060
Nurse Practitioner (Family)
790 CHURCH ST NE, SUITE 330
MARIETTA, GA 30060
Durable Medical Equipment & Medical Supplies
790 CHURCH ST NE, SUITE 335
MARIETTA, GA 30060
Family Medicine
790 CHURCH ST NE, SUITE 250
MARIETTA, GA 30060

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1225317365, enumerated as an "individual" on August 08, 2011.

The provider is located at 790 CHURCH ST NE SUITE 400 MARIETTA, GA 30060 and the phone number is (770) 952-8899.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.

Kevin Ballard is affiliated with: WELLSTAR KENNESTONE REGIONAL MEDICAL CENTER, WELLSTAR PAULDING MEDICAL CENTER, WELLSTAR COBB MEDICAL CENTER and WELLSTAR DOUGLAS MEDICAL CENTER.