SHANICKQUA BALLARD NP
NPI 1588401103
Nurse Practitioner - Primary Care in Chesapeake, VA

Q: What is Shanickqua Ballard's NPI number?

The NPI number for Shanickqua Ballard is 1588401103. It was assigned to this individual provider in the NPPES registry on July 10, 2024.

Q: What is Shanickqua Ballard's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Active since July 10, 2024PECOS Enrolled

200 CARMICHAEL WAY STE 606, CHESAPEAKE, VA 23322(757) 401-4163 Get Directions Write a Review

NPPES record last updated: May 21, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 21, 2025, Oct 7, 2024, Jul 10, 2024 (3 updates tracked since 2024).

On this page

About Shanickqua Ballard Np NPPES

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

SHANICKQUA BALLARD NP (NPI 1588401103) is an individual primary care provider in Chesapeake, Virginia, licensed in Virginia (0024190636) and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588401103

Entity TypeIndividualFemale

Primary Taxonomy363LP2300X

Provider Legal NameSHANICKQUA BALLARDCredential: NP

Location Address200 CARMICHAEL WAY STE 606Chesapeake, VA 23322-2489

Mailing Address1108 Merchants Ct Apt 3bChesapeake, VA 23320-7417 · (718) 404-3279

Phone(757) 401-4163

Sole ProprietorNo

Enumeration DateJuly 10, 2024

Last NPPES UpdateMay 21, 20253 updates tracked since enumeration

NPPES CertifiedMay 21, 2025

✔ NPI 1588401103 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

License✔ Licensed in VA · 0024190636

200 CARMICHAEL WAY STE 606, Chesapeake, VA 23322

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shanickqua Ballard Np 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.

Medicare Billing Reassignment

Medicare enrollment records show Shanickqua Ballard reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Tidewater Physicians Multispecialty Group PC

32 mi

Family Medicine

860 OMNI BLVD STE 401
Newport News, VA 23606

Reassigned Medicare billing, Virginia enrollment
351 clinicians in this Medicare group

NPI 1902848294 (757) 232-8764

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23322 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

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$99.13 typical visit price

range $18.07 – $138.91

Typical copayment $24.78 (range $4.51 – $34.72)

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 5

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

TIFFANY-POLYNNE T YANG PA-C

Physician Assistant