BRIAN R INGRAM (NPI# 1700368495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700368495 |
| Entity Type | Individual |
| Full Name | BRIAN R INGRAM |
| Credential | PA |
| Practice Address |
1851 Old Hwy 66 Edgewood NM 87015 |
| Mailing Address |
12127b Hwy 14 N Ste 5 Cedar Crest NM 87008-9499 |
| Practice Telephone | 5052862396 |
| Practice Fax Number | 5052862398 |
| Mailing Telephone | 5052815180 |
| Mailing Fax Number | 5052815320 |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2018-08-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA2018-0050 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609356039 | Brian Russell Ingram | Student in an Organized Health Care Education/Training Program | 4371 Narrow Lane Rd Ste 100, Montgomery, AL 36116-2975 | 2018-08-15 |
| 1811380611 | Brian Woods Ingram | Physician Assistant | 1604 E 8th St Ste A, Weslaco, TX 78596-5587 | 2015-03-18 |
| 1659322188 | Brian Grant Ingram | Physician Assistant | 205 N East Ave, Jackson, MI 49201-1753 | 2006-05-12 |
| Street Address |
1851 OLD HWY 66 |
| City | EDGEWOOD |
| State | NM |
| Zip Code | 87015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396870861 | Stephen L Harrington | Dentist | 1851 Old Hwy 66, Suite C, Edgewood, NM 87015 | 2007-02-23 |
| 1700393782 | Mcleod Medical Centers of Nm, Inc. | Family Medicine | 1851 Old Hwy 66, Edgewood, NM 87015 | 2017-12-29 |
| 1851849806 | Margaret Barbour Von Hendricks | Nurse Practitioner | 1851 Old Hwy 66, Edgewood, NM 87015 | 2016-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740772490 | Laura Hunsucker | Physical Therapist | 1090 Mountain Valley Road, Edgewood, NM 87015 | 2018-05-30 |
| 1295194629 | Ryan Grange | Physician Assistant | 1851 Old Highway 66 Unit 1, Edgewood, NM 87015 | 2016-02-12 |
| 1376895250 | Bianca Genco-morrison | Social Worker | 17 Venus Rd. West, Edgewood, NM 87015 | 2012-10-03 |
| 1447541909 | Rona H Vanwilligen | Physical Therapist | 1851 Highway 333, 2-b, Edgewood, NM 87015 | 2011-05-02 |
| 1679717789 | Alan Mannheimer | Pediatrics | 104 Quail Trail, Unit B, Edgewood, NM 87015 | 2009-04-21 |
| 1003085705 | Wal-mart Stores East, Lp | Eyewear Supplier (Equipment, not the service) | 66 State Road #344, Edgewood, NM 87015 | 2008-02-27 |
| 1821270828 | Fowler Enterprises, Inc. | Physical Therapist | 1851-2b Old Highway 66, Edgewood, NM 87015 | 2007-11-30 |
| 1366630121 | Jeana Spindle | Speech-Language Pathologist | 27 Camino Estribor, Edgewood, NM 87015 | 2007-10-05 |
| 1679794457 | Sharon Louise Meyer | Social Worker | 14 El Prado, Edgewood, NM 87015 | 2007-05-01 |
| 1912035478 | Cecilia Gonzales Morris | Occupational Therapist | 204 Dinkle Road, Edgewood, NM 87015 | 2007-02-28 |
| Find all providers in zip 87015 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811543812 | Emily Crocetti | Physician Assistant | 20 Medical Village Dr Ste 132, Edgewood, KY 41017-5406 | 2019-08-15 |
| 1053528380 | Casey Lynn Doty | Physician Assistant | 20 Medical Village Dr # 254, Edgewood, KY 41017 | 2007-05-17 |
| 1083212344 | Kelly O'brien | Physician Assistant | 900 Medical Village Dr, Edgewood, KY 41017-3422 | 2020-10-09 |
| 1255957122 | Lauren Slabaugh | Physician Assistant | 162 Barnwood Dr, Edgewood, KY 41017-2501 | 2020-06-17 |
| 1700422995 | Samuel Jacob Dedden | Physician Assistant | 560 S Loop Rd, Edgewood, KY 41017-3405 | 2019-11-21 |
| 1033628268 | Jennifer Teresa Sprague | Physician Assistant | 20 Medical Village Dr, Edgewood, KY 41017-5401 | 2017-09-20 |
| 1932624707 | Thomas Slone Wilkinson | Physician Assistant | 1 Medical Village Dr, Edgewood, KY 41017-3403 | 2017-08-13 |
| 1215380100 | Madeleine Lansberry | Physician Assistant | 200 Medical Village Dr, Edgewood, KY 41017 | 2016-07-15 |
| 1922463918 | Nicholas Joseph Reist | Physician Assistant | 560 S Loop Rd, Edgewood, KY 41017-3405 | 2015-12-18 |
| 1275903320 | Jaclyn Lunsford | Physician Assistant | 200 Medical Village Dr, Edgewood, KY 41017 | 2015-10-01 |
| Find all providers in EDGEWOOD | ||||
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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.