JOHN JOHN DAVID BALOUN ACNP-BC NPI 1821327917
Nurse Practitioner in Lebanon, TN
About JOHN JOHN DAVID BALOUN ACNP-BC
John Baloun is a provider established in Lebanon, Tennessee and his medical specialization is Nurse Practitioner with more than 15 years of experience. He graduated from Vanderbilt University School Of Medicine in 2009. The healthcare provider is registered in the NPI registry with number 1821327917 assigned on December 2009. The practitioner's primary taxonomy code is 363L00000X with license number 14661 (TN). The provider is registered as an individual and his NPI record was last updated 7 years ago.
| NPI | 1821327917 |
| Provider Name | JOHN JOHN DAVID BALOUN ACNP-BC |
| Location Address | 1411 W BADDOUR PKWY LEBANON, TN 37087 |
| Location Phone | (615) 443-2531 |
| Mailing Address | 649A HARRIS LN GALLATIN, TN 37066 |
| Gender | Male |
| Entity Type | Individual |
| Medical School Name | VANDERBILT UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2009 |
| Is Sole Proprietor? | No |
| Enumeration Date | 12-18-2009 |
| Last Update Date | 12-09-2016 |
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A nurse practitioner (NP) like John Baloun is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
John Baloun 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.
The provider participated in CMS Quality Payment Program and the following quality measures were reported: implementation of an asp, implementation of formal quality improvement methods, practice changes, or other practice improvement processes, measurement and improvement at the practice and panel level and participation in an ahrq-listed patient safety organization.. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.08 for a new patient copayment and $24.46 for an established patient copayment.
Business Address
1411 W BADDOUR PKWY
LEBANON, TN
ZIP 37087
Phone: (615) 443-2531
Fax: (615) 443-2524
Mailing Address
649A HARRIS LN
GALLATIN, TN
ZIP 37066
Phone: (615) 339-4249
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.
| Taxonomy Code | 363L00000X |
| Classification | Nurse Practitioner |
| Type | Physician Assistants & Advanced Practice Nursing Providers |
| License No. | 14661 |
| License State | TN |
| Taxonomy Description | (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
Location Map
PECOS Enrollment and Medicare Participation Status
John Baloun 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.
Registered in PECOS? Yes
PECOS PAC ID: 1658327911
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: I20101029001222
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
Physician Visit Costs
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 37087 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.32
- Minimum New Patient Price $54.58
- Maximum New Patient Price $167.19
- Average New Patient Copayment $21.08
- Minimum New Patient Copayment $13.64
- Maximum New Patient Copayment $41.79
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $97.84
- Minimum Established Patient Price $16.86
- Maximum Established Patient Price $136.82
- Average Established Patient Copayment $24.46
- Minimum Established Patient Copayment $4.21
- Maximum Established Patient Copayment $34.2
* 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.
Quality Reporting
The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Implementation of an ASP | Yes | N/A |
| Change Activity Description to: Leadership of an Antimicrobial Stewardship Program (ASP) that includes implementation of an ASP that measures the appropriate use of antibiotics for several different conditions (such as but not limited to upper respiratory infection treatment in children, diagnosis of pharyngitis, bronchitis treatment in adults) according to clinical guidelines for diagnostics and therapeutics. Specific activities may include: • Develop facility-specific antibiogram and prepare report of findings with specific action plan that aligns with overall facility or practice strategic plan. • Lead the development, implementation, and monitoring of patient care and patient safety protocols for the delivery of ASP including protocols pertaining to the most appropriate setting for such services (i.e., outpatient or inpatient). • Assist in improving ASP service line efficiency and effectiveness by evaluating and recommending improvements in the management structure and workflow of ASP processes. • Manage compliance of the ASP policies and assist with implementation of corrective actions in accordance with facility or clinic compliance policies and hospital medical staff by-laws. • Lead the education and training of professional support staff for the purpose of maintaining an efficient and effective ASP. • Coordinate communications between ASP management and facility or practice personnel regarding activities, services, and operational/clinical protocols to achieve overall compliance and understanding of the ASP. • Assist, at the request of the facility or practice, in preparing for and responding to third-party requests, including but not limited to payer audits, governmental inquiries, and professional inquiries that pertain to the ASP service line. • Implementing and tracking an evidence-based policy or practice aimed at improving antibiotic prescribing practices for high-priority conditions. • Developing and implementing evidence-based protocols and decision-support for diagnosis and treatment of common infections. • Implementing evidence-based protocols that align with recommendations in the Centers for Disease Control and Prevention’s Core Elements of Outpatient Antibiotic Stewardship guidance | ||
| Implementation of formal quality improvement methods, practice changes, or other practice improvement processes | Yes | N/A |
| Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Participation in an AHRQ-listed patient safety organization. | Yes | N/A |
| Participation in an AHRQ-listed patient safety organization. | ||
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 8 | 2 | 1 | 3 | 2 | 7 | 9 | 1 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 4 | 1 | 6 | 2 | 14 | 9 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 4 + 1 + 6 + 2 + 1 + 4 + 9 + 2 + 24 = 63 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 63 = 7 | 7 | ||||||||
The NPI number 1821327917 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
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Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1720056716 | KELLYE DYKES CRNA Individual | Nurse Anesthetist, Certified Registered | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 256-1064 |
| 1033187638 | ERIC SALSER CRNA Individual | Nurse Anesthetist, Certified Registered | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 256-1064 |
| 1760450241 | FREDERICK SCHRIMPE CRNA Individual | Nurse Anesthetist, Certified Registered | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 256-1064 |
| 1629046164 | DEBORAH HAAS CRNA Individual | Nurse Anesthetist, Certified Registered | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 256-1064 |
| 1316915614 | JOHN MOORE CRNA Individual | Nurse Anesthetist, Certified Registered | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 256-1064 |
| 1164490488 | JULIE TERRY CRNA Individual | Nurse Anesthetist, Certified Registered | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 256-1064 |
| 1144299496 | BARBARA VOLNER CRNA Individual | Nurse Anesthetist, Certified Registered | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 256-1064 |
| 1154380723 | JAMES FYKE CRNA Individual | Nurse Anesthetist, Certified Registered | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 256-1064 |
| 1386697126 | DR. MARION ALLEN MCFARLAND M.D. Individual | Emergency Medicine | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 443-2531 |
| 1740216688 | JOHN LAURENCE BUTCHER MD Individual | Emergency Medicine | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 443-2531 |
| 1669406674 | UAA PC INC Organization | Nurse Anesthetist, Certified Registered | 1411 W BADDOUR PKWY LEBANON, TN 37087 (813) 287-5718 |
| 1295769495 | ANESTHESIA SERVICES OF WILSON COUNTY PLLC Organization | Anesthesiology | 1411 W BADDOUR PKWY LEBANON, TN 37087 (813) 287-5718 |
| 1568576825 | NANCYE R. HALEY M.D. Individual | Emergency Medicine | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 444-2320 |
| 1790899078 | JEFFREY FLEMING LIVINGSTON M.D. Individual | Emergency Medicine | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 444-2320 |
| 1124344882 | LEBANON EMERGENCY PHYSICIANS, PLLC Organization | Emergency Medicine | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 444-8262 |
| 1164742300 | TENNESSEE EM-I MEDICAL SERVICES PC Organization | Physician Assistant | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 444-8262 |
| 1548575400 | AVE MARIA MEDICAL PLLC Organization | Internal Medicine | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 443-2544 |
| 1063774552 | LEBANON HMA, LLC Organization | Internal Medicine (Cardiovascular Disease) | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 443-2500 |
| 1013114685 | DR. CHARLES EDDIE WATERS PHARMD, BCPS, CGP Individual | Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist) | 1411 W BADDOUR PKWY LEBANON, TN 37087 (678) 314-0983 |
| 1598158560 | BRANDON SAUNDERS FNP-BC Individual | Nurse Practitioner (Family) | 1411 W BADDOUR PKWY LEBANON, TN 37087 (615) 202-1694 |
Frequently Asked Questions
What is John Baloun ACNP-BC NPI number?
The NPI number assigned to this healthcare provider is 1821327917, enumerated in the NPI registry as an "individual" on December 18, 2009
Where is the provider located?
The provider is located at 1411 W Baddour Pkwy Lebanon, Tn 37087 and the phone number is (615) 443-2531
What is the provider specialty code?
The provider's speciality is Nurse Practitioner with taxonomy code 363L00000X
How many years of experience does John Baloun ACNP-BC have?
The provider has more than 15 years of experience. He graduated from Vanderbilt University School Of Medicine in 2009.
Is John Baloun ACNP-BC registered in PECOS?
Yes, as of December 01, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.
How much is a visit to John Baloun ACNP-BC?
Medicare beneficiaries should expect a typical cost of $84.32 with an average copayment of $21.08 for new patient appointments. Established patients should expect a typical charge of $97.84 and an average copayment of 24.46. Please review your insurance plan or contact the provider directly to determine your specific costs.
How do I update my NPI information?
This NPI record was last updated on December 18, 2009. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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