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Kathleen Marie Ballard

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as KATHLEEN BALLARD.

Based on the most recent information from CMS, provider Kathleen Marie Ballard is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 2:35 PM.

Profile Details

Provider ID
1316352362
Provider Type
Individual
Full Name
Ballard, Kathleen Marie
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
6/29/2014
Last Updated
11/8/2023

Contact Information

Practice Location

22 Bramhall St, Portland, ME 04102-3134

(207) 774-2381

(207) 774-0459

Mailing Location

887 Congress St Ste 400, Portland, ME 04102-3163

(207) 774-6368

(207) 662-7996

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA1494 Maine

Kathleen Marie Ballard

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Whitney, Elizabeth

Macleod, Courtney C.

Wallace, Chase E

Roth, Charles J.

Hazen, Gordon Loughlin

Lavoie, Sarah A

Bessey, Kristie L

Nelligan, William Woodward

Winkler, Emma Jane

Large, Daniel