JACK INGRAM (NPI# 1518412949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518412949 |
| Entity Type | Individual |
| Full Name | JACK INGRAM |
| Credential | M.D. |
| Practice Address |
1500 S Main St Ft Worth TX 76104-4917 |
| Practice Telephone | 8177023431 |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2016-08-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
BP10055948 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
1500 S MAIN ST |
| City | FT WORTH |
| State | TX |
| Zip Code | 76104-4917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306466875 | Scott Brockwell Mathis | Student in an Organized Health Care Education/Training Program | 1500 S Main St, Ft Worth, TX 76104-4917 | 2020-04-24 |
| 1497398531 | Liza Munoz Rodriguez | Nurse Practitioner | 1500 S Main St, Ft Worth, TX 76104-4917 | 2019-10-22 |
| 1407418924 | Amanda Rae Arreola | Student in an Organized Health Care Education/Training Program | 1500 S Main St, Ft Worth, TX 76104-4917 | 2019-07-04 |
| 1053872572 | Samuel Crist | Student in an Organized Health Care Education/Training Program | 1500 S Main St, Ft Worth, TX 76104-4917 | 2019-03-27 |
| 1104386564 | Jane Elizabeth Gilmore | Student in an Organized Health Care Education/Training Program | 1500 S Main St, Ft Worth, TX 76104-4917 | 2019-03-21 |
| 1306338801 | Joel Ortlip | Student in an Organized Health Care Education/Training Program | 1500 S Main St, Ft Worth, TX 76104-4941 | 2018-05-31 |
| 1518461946 | Dwain Paul Strickland | Student in an Organized Health Care Education/Training Program | 1500 S Main St, Ft Worth, TX 76104-4917 | 2018-03-20 |
| 1639673056 | Jonathan Norman Hardy | Emergency Medicine | 1500 S Main St, Ft Worth, TX 76104-4941 | 2018-03-20 |
| 1457803124 | Lashindra Fisher | Nurse Practitioner | 1500 S Main St, Ft Worth, TX 76104-4917 | 2016-10-28 |
| 1902253479 | Ian S. Lehrer | Dentist | 1500 S Main St, Ft Worth, TX 76104-4917 | 2016-05-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366524993 | Ross Tatum | Psychiatry & Neurology | 3815 Lisbon St Ste 200, Ft Worth, TX 76107-5673 | 2006-10-20 |
| 1457399842 | Farrukh L Bhatti | Psychiatry & Neurology | 7021 Shinnecock Hills Dr, Ft Worth, TX 76132-7123 | 2006-06-04 |
| 1033181672 | Jeffrey Melvin Schlueter | Psychiatry & Neurology | 3109 6th Ave, Suite B, Ft Worth, TX 76110-3800 | 2006-02-07 |
| 1972664928 | Rupinder Singh Bhatia,m.d., P.a. | Psychiatry & Neurology | 1220 W Presidio St, Ft Worth, TX 76102-4512 | 2006-12-13 |
| 1700957230 | Rupinder Singh Bhatia | Psychiatry & Neurology | 1220 W Presidio St, Ft Worth, TX 76102-4512 | 2006-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750997920 | Pearland Psychiatric Associates Pllc | Psychiatry & Neurology | 2743 Smith Ranch Rd Unit 101, Pearland, TX 77584-5205 | 2020-09-22 |
| 1821604364 | Mindful Brain Health Pllc | Psychiatry & Neurology | 4012 Hoyer Cv, Round Rock, TX 78681-1045 | 2020-09-21 |
| 1013523604 | Stephen Oravec | Psychiatry & Neurology | 952 Danny Sanchez Pl, Anthony, TX 79821-7365 | 2020-09-18 |
| 1063028884 | West Texas Tms Pllc | Psychiatry & Neurology | 4601 Buffalo Gap Rd Ste B3, Abilene, TX 79606-3362 | 2020-09-17 |
| 1386267466 | Sharon Marjorie Tomlinson | Psychiatry & Neurology | 705 Bray Central Dr Apt 9306, Allen, TX 75013-6377 | 2020-05-22 |
| 1821610528 | Dr Erum Psychiatry, Pllc | Psychiatry & Neurology | 2425 N Central Expy Ste 700, Richardson, TX 75080-2860 | 2020-05-15 |
| 1366062358 | Luckhart Psychiatry, Pllc | Psychiatry & Neurology | 7100 Boulevard 26 Ste 101, Richland Hills, TX 76180-8687 | 2020-04-20 |
| 1093334104 | Phoenix Mental Health Tms | Psychiatry & Neurology | 19707 Ih 10 W Ste 314, San Antonio, TX 78257-1746 | 2020-04-09 |
| 1104445220 | Neogen Mental Health and Behavioral Services, Pa. | Psychiatry & Neurology | 2141 Kirkwood Blvd Ste 130, Southlake, TX 76092-1464 | 2020-04-09 |
| 1154950459 | Compass Psychiatry Solutions | Psychiatry & Neurology | 2026 Wirt Rd Fl 2, Houston, TX 77055-1626 | 2020-04-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.