NPIMap

Organization Active NPI

Ingram Anesthesia Inc

  • Certified Registered Nurse Anesthetist
  • Athens, GA
National Provider Identifier
1073767182
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN107878 Issued in GA
Legal business name
INGRAM ANESTHESIA INC
Practice address
1750 S Lumpkin St
Athens, GA 30606-4739
Phone
(706) 353-2550
NPI assigned
Nov 17, 2008
Last updated
Sep 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Authorized official

Name
William Scott Ingram, CRNANPI 1215951256
Title
President
Phone
(478) 231-9507

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN107878 GA Primary

Addresses

Primary practice location

1750 S Lumpkin St
Athens, GA 30606-4739

Mailing address

111 Kilsprings Rd
Anderson, SC 29621-4224

Other identifiers 1

IdentifierTypeStateIssuer
632655268AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090701000257 GA Part B Supplier - Clinic/Group Practice 6507917697 Receives reassigned benefits from 6 practitioners
Practice locations: Athens, GA; Columbus, GA; Gainesville, GA; Smyrna, GA

National Provider Directory

National Provider Directory

Locations

1750 S Lumpkin St
Athens, GA 30606
Phone (706) 353-2550

2806 Hillcreek Dr
Augusta, GA 30909
Phone (706) 863-0200

2100 North Ave
Columbus, GA 31904
Phone (706) 243-0624

1206A Sherwood Park Dr NE
Gainesville, GA 30501
Phone (770) 534-1230

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1073767182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 KILSPRINGS RD",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 S LUMPKIN ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306064739",
            "telephone_number": "706-353-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGRAM ANESTHESIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-17",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-231-9507",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN107878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "632655268A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.