AMANDA L BALLARD (CSAC, SAC-IT, OT) – Addiction (Substance Use Disorder) Counselor, NPI 1851546667
Addiction (Substance Use Disorder) Counselor
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
973 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in IL
Provider Addresses for AMANDA L BALLARD (CSAC, SAC-IT, OT)
4730 Squaw Prairie Rd
Belvidere, IL 610088800
Phone: (815) 544-9495
Type: Location
1401 E State St
Rockford, IL 611042315
Phone: (779) 489-4595
Type: Location
200 1st St SW
Rochester, MN 559050001
Phone: (507) 284-2511
Type: Location
29624 NETWORK PL
CHICAGO, IL 606731296
Phone:
Type: Mailing
Humes Road, Janesville, Rock County, Wisconsin, 53547, United States
JANESVILLE, WI 535450491
Phone: (608) 741-2117
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2026-03-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20260313001653 | I | Occupational Therapist In Private Practice | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 61008)
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