Active NPI
Marquis Ingram
- Basic Emergency Medical Technician
- Savannah, GA
National Provider Identifier
1003514167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Basic Emergency Medical Technician
- License
- 202183102250
- Practice address
- 11330 White Bluff Rd Unit 37
Savannah, GA 31419-1579 - Phone
- (912) 777-2865
- NPI assigned
- Feb 20, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | 202183102250 | GA | Primary |
Addresses
Primary practice location
11330 White Bluff Rd Unit 37
Savannah, GA 31419-1579
Mailing address
11330 White Bluff Rd Unit 37
Savannah, GA 31419-1579
Phone (912) 777-2865
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 922414946 | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202183102250 | GA | MD | Basic Emergency Medical Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676851200000",
"number": "1003514167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11330 WHITE BLUFF RD UNIT 37",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314191579",
"telephone_number": "912-777-2865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11330 WHITE BLUFF RD UNIT 37",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314191579",
"telephone_number": "912-777-2865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGRAM",
"first_name": "MARQUIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-02-20",
"last_updated": "2023-02-20",
"certification_date": "2023-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "GA",
"license": "202183102250",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "922414946",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Savannah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.