Provider Demographics
NPI:1972582096
Name:BALLINGER, JEANNE FIELDS (MD)
Entity Type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:FIELDS
Last Name:BALLINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-851-6033
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:4230 HARDING PIKE
Practice Address - Street 2:SUITE 302W
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-292-7708
Practice Address - Fax:615-292-7756
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13853174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6028180OtherBCBS TN
TN13853OtherMEDICAL LICENSE
TNQ010374Medicaid
TNQ010374Medicaid
TNAB1531222OtherDEA
TNB59492Medicare UPIN