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SALLY J BALLARD PA-C
NPI 1720288756
Physician Assistant - Medical in Goreville, IL

Active since July 18, 2007
200 S BROADWAY, GOREVILLE, IL 62939(618) 995-2396(618) 995-2947 Get Directions Write a Review

NPPES record last updated: November 12, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Sally J Ballard Pa-c NPPES

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

SALLY J BALLARD PA-C (NPI 1720288756) is an individual medical provider in Goreville, Illinois and active in the NPI registry since July 2007.

NPPES Registry Identity

NPI1720288756
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameSALLY J BALLARDCredential: PA-C
Location Address200 S BROADWAYGoreville, IL 62939
Mailing Address200 S Broadway, Po Box 40Goreville, IL 62939 · (618) 995-2396 · Fax (618) 995-2947
Phone(618) 995-2396
Fax(618) 995-2947
Sole ProprietorNo
Enumeration DateJuly 18, 2007
Last NPPES UpdateNovember 12, 2007
✔ NPI 1720288756 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
200 S BROADWAY, Goreville, IL 62939
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Other Identifiers 2

Other215389IL · Medicare Group Number
Medicare PINK40932IL

Other Providers at the Same Location NPPES

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

CLS MEDICAL INC.
Clinic/Center (Primary Care)
200 S BROADWAY
GOREVILLE, IL 62939
Johnson County (618) 995-2396

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 Sally Ballard's NPI number?

The NPI number for Sally Ballard is 1720288756. It was assigned to this individual provider in the NPPES registry on July 18, 2007.

Where is Sally Ballard located?

Sally Ballard practices at 200 S Broadway, Goreville, IL 62939. The listed phone number is (618) 995-2396.

What is Sally Ballard's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Sally Ballard was last updated on November 12, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.