CARL ANDREW BALLARD FNP-C
NPI 1386243574
Nurse Practitioner - Family in Detroit, AL

Active since October 20, 2020PECOS EnrolledAccepts Medicare Assignment
93.1/100
CMS Quality Rating
2635 JOHNSON BOTTOM RD, DETROIT, AL 35552(205) 495-0545 Get Directions Write a Review

NPPES record last updated: October 20, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Carl Andrew Ballard Fnp-c NPPES

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

CARL ANDREW BALLARD FNP-C (NPI 1386243574) is an individual family provider in Detroit, Alabama, licensed in Mississippi (904235) and active in the NPI registry since October 2020. He is enrolled in Medicare PECOS, is affiliated with North Mississippi Medical Center, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1386243574
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameCARL ANDREW BALLARDCredential: FNP-C
Location Address2635 JOHNSON BOTTOM RDDetroit, AL 35552-2731
Mailing Address2635 Johnson Bottom RdDetroit, AL 35552-2731
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateOctober 20, 2020
NPPES CertifiedOctober 20, 2020
NPI 1386243574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in MS · 904235
2635 JOHNSON BOTTOM RD, Detroit, AL 35552

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Carl Andrew Ballard Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3577971019
PECOS Enrollment IDI20210421001587
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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
79 services79 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
47 services47 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
45 services44 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
27 services27 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
16 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

North Mississippi Medical Center

Acute Care Hospitals · Tupelo, MS
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number250004
Location830 S Gloster StreetTupelo, MS 38801 · Lee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35552 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
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

93.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality83.08
Promoting Interoperability88
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers13 claims13 services$19.76 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
5 suppliers15 claims15 services$111.81 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Carl Ballard's NPI number?

The NPI number for Carl Ballard is 1386243574. It was assigned to this individual provider in the NPPES registry on October 20, 2020.

Where is Carl Ballard located?

Carl Ballard practices at 2635 Johnson Bottom Rd, Detroit, AL 35552. The listed phone number is (205) 495-0545.

What is Carl Ballard's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Carl Ballard enrolled in Medicare?

Yes. Carl Ballard is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Carl Ballard accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 3 other insurers list Carl Ballard as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Carl Ballard affiliated with any hospitals?

According to CMS data, Carl Ballard is affiliated with North Mississippi Medical Center.

When was this NPI record last updated?

The NPPES record for Carl Ballard was last updated on October 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.