LANDON BALLMAN – Nurse Practitioner, NPI 1669352480

LANDON BALLMAN is a healthcare provider. based in Fort worth, Texas. specializing in NURSE PRACTITIONER. They hold a License No. 1158226 (TX). The NPI Number for LANDON BALLMAN is 1669352480

Main info

Organization
Sole Proprietor
3 Years Of Experience
Name
LANDON BALLMAN
NPI
1669352480
Phone
(817) 321-0404
Address
1320 S UNIVERSITY DR STE 500
Enumeration Date
3 September 2025
Last Update Date
31 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8179345499
Graduation Year
2023 (3 years ago)
PAC ID
5496240830
Group Practice PAC ID
8729429592
Professional Enrollment ID
I20251223001157
Address ID
TX761044155FO1622XAVEX303
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness85
Years active:0State licenses:2Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for LANDON BALLMAN

  • 1320 S UNIVERSITY DR STE 500

    FORT WORTH, TX 761075732

    Phone: (817) 321-0404

    Type: Mailing

  • 11801 SOUTH FWY

    BURLESON, TX 760287021

    Phone: (817) 293-9110

    Type: Location

  • 815 Pennsylvania Ave

    Fort Worth, TX 761042294

    Phone: (817) 321-0404

    Type: Location

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: 2025-12-23

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
I20251223001157INurse PractitionerTXTBD

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 76107)

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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: 8729429592View full group profile
NameSpecialtyState
Nurse PractitionerTX
Physician AssistantTX
Physician AssistantTX
Physician AssistantTX
Physician AssistantTX
Physician AssistantTX
Physician AssistantTX
Nurse PractitionerTX
Physician AssistantTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

What NPI should I save for LANDON BALLMAN?
Save NPI 1669352480 if you need a stable reference for LANDON BALLMAN.
Is LANDON BALLMAN's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does LANDON BALLMAN list a primary specialty?
If you are matching referrals, note Nurse Practitioner for LANDON BALLMAN. Clinical services aligned with this taxonomy classification.
What location shows for LANDON BALLMAN?
We surface Fort Worth, Texas for LANDON BALLMAN based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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