Daniel Wayne Ingham, CRM

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

22-CRM-978 Issued in OR

Practice address

1003 E Main St Ste 104
Medford, OR 97504-7140

Phone

(541) 779-1282

NPI assigned

Apr 14, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Addictions Recovery Center, Inc.

  • Substance Abuse Rehabilitation Facility
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  • NPI 1346282035
  NPD

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1083357339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 E MAIN ST STE 104",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047140",
            "telephone_number": "541-779-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 E MAIN ST STE 104",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047140",
            "telephone_number": "541-779-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGHAM",
        "first_name": "DANIEL",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "CRM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-14",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "22-CRM-978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sundus Ikram, MD
• Imaginears, Inc.
• Impact of Oregon LLC
• Paul S Imperia, M.D.
• Valerie Kathryn Indihar, QMHA-R
• Rebecca Anne Ingram-Walrod
• Amber Ingram, QMHA, PSS
• Gary Lohrenz Ingram, MD
• Katherine Patricia Ingram, MA
• Inner Flow Counseling LLC

• Peer Specialist in Medford, OR
• Providers in Medford, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.