Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Willie Benjamin Ballou, NP-C

Individual provider Adult Health Nurse Practitioner · NPI 1548657802

Willie Benjamin Ballou, NP-C is a Nurse Practitioner in Tempe, Arizona. Qualified in 2014, 12 years ago. Works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Arizona and Texas.

Years since qualifying
12
Licensed in
AZ, TX
In the registry since
2015
Specialties on file
2
What do these letters mean?
NP-C — Nurse Practitioner, Certified
A nurse practitioner certified by the AANP.

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Practice location Address checks out

4041 S McClintock Dr
Tempe, AZ 85282-5879
Phone: (520) 233-7111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2718 Skyview Point Dr, Houston, TX 77047-8122 — (281) 908-6346

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 229136 (AZ)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence AP127755 (TX)

Record details

NPI number1548657802
Entity typeIndividual (Type 1)
GenderMale
Credentials NP-C
Sole proprietorNo
NPI enumeratedApril 23, 2015
Last updated in NPPESJuly 7, 2021
Certification dateJuly 7, 2021
Mailing address4041 S McClintock Dr, Ste 311, Tempe, AZ 85282-5879

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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