NPIMap

Individual provider Active NPI

Russell D. Ingram, M.D.

  • Family Medicine Physician
  • Bethany, OK
National Provider Identifier
1043475353
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26430 Issued in OK
Practice address
7530 NW 23Rd St
Bethany, OK 73008-4921
Phone
(405) 787-8550
Fax
(405) 787-4982
NPI assigned
Jul 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26430 OK Primary

Addresses

Primary practice location

7530 NW 23Rd St
Bethany, OK 73008-4921

Mailing address

7530 NW 23Rd St
Bethany, OK 73008-4921
Phone (405) 787-8550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091020000729 OK Practitioner - Family PracticePractitioner - Emergency Medicine 4789721986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Physicians Group, LLCGroup PAC ID 8325950603, 107 clinicians

Practice addresses (Care Compare)

10021 S Western Ave
Oklahoma City, OK 73139-2927
Phone (405) 692-9300

1616 S Kelly Ave
Edmond, OK 73013-3651
Phone (405) 330-0032

Hospital & facility affiliations

  • A Path of Care Home Health III, Inc Home health agency, Yukon, OK, CCN 377448
  • Trinity Hospice Hospice, Oklahoma City, OK, CCN 371646
  • Community Hospital, LLC Hospital, Oklahoma City, OK, CCN 370203
  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
  • SSM Health St Anthony Hospital - Oklahoma City Hospital, Oklahoma City, OK, CCN 370037
  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Physicians Group LLC Family Medicine CurrentSince Mar 1, 2014 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

7530 NW 23rd St
Bethany, OK 73008
Phone (405) 730-6990

1705 Renaissance Blvd
Ste 120
Edmond, OK 73013
Phone (405) 715-4496

9060 Harmony Dr
Ste B
Oklahoma City, OK 73130
Phone (405) 733-4447

10021 S Western Ave
Oklahoma City, OK 73139
Phone (405) 692-9300

4400 Grant Blvd
Yukon, OK 73099
Phone (405) 467-4440

Interoperability endpoints

  • Direct secure messaging: russell.ingram@gilmed.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/DCGDCA

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1043475353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7530 NW 23RD ST",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730084921",
            "telephone_number": "405-787-8550",
            "fax_number": "405-787-4982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7530 NW 23RD ST",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730084921",
            "telephone_number": "405-787-8550",
            "fax_number": "405-787-4982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "RUSSELL",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-25",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "26430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethany, OK

Sources for this page

Verify at the official NPI Registry.