KEVIN D BALLARD (NP) – Nurse Practitioner, NPI 1700825981

KEVIN D BALLARD (NP) is a healthcare provider. based in Crookston, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. R28679 (MN). The NPI Number for KEVIN D BALLARD (NP) is 1700825981

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN D BALLARD (NP)
NPI
1700825981
Phone
(218) 253-4606
Address
323 S MINNESOTA ST
Enumeration Date
5 June 2006
Last Update Date
19 September 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3207487223
Graduation Year
1995 (31 years ago)
PAC ID
2860388931
Group Practice PAC ID
4385556885
Professional Enrollment ID
I20040225000718
Address ID
MN562404845GR115XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

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Provider Addresses for KEVIN D BALLARD (NP)

  • Riverview Health, 323, South Minnesota Street, Crookston, Polk County, Minnesota, 56716, United States

    CROOKSTON, MN 567161601

    Phone: (218) 253-4606

    Mailing address matches the actual address.

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: 2004-02-25

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040225000718INurse PractitionerMNTBD

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.

Verify on CMS Revalidation Lookup Tool

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 56716)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4385556885View full group profile
NameSpecialtyState
Family PracticeMN
Nurse PractitionerMN
Nurse PractitionerND
Nurse PractitionerND

Reviews

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Frequently asked questions

What is the registry number for KEVIN D BALLARD (NP)?
The registry entry for KEVIN D BALLARD (NP) shows NPI 1700825981.
Quick check: is KEVIN D BALLARD (NP) active?
Public NPPES data shows KEVIN D BALLARD (NP) with an active NPI status right now.
What services align with KEVIN D BALLARD (NP)'s listing?
KEVIN D BALLARD (NP)'s public classification highlights Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to KEVIN D BALLARD (NP)?
The directory associates KEVIN D BALLARD (NP) with Crookston, Minnesota. Check all listed addresses for suites or satellite offices.
Can I export KEVIN D BALLARD (NP)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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