Individual provider Active NPI

Jenifer Ingle

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1124293881
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2011-01206 Issued in NC
Practice address
200 S College St
Suite 500
Charlotte, NC 28202-2012
Phone
(704) 302-8800
Fax
(704) 632-4001
NPI assigned
Apr 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 149274 NC
Internal Medicine Physician 207R00000X 2011-01206 NC Primary

Addresses

Primary practice location

200 S College St
Suite 500
Charlotte, NC 28202-2012

Mailing address

200 S College St
Ste 500
Charlotte, NC 28202-2067
Phone (704) 302-8800

Other identifiers 3

IdentifierTypeStateIssuer
5918984MedicaidNC
1124293881MedicaidNC
NC1488MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110919000013 NC Practitioner - Internal Medicine 2860663168

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

548 White Oaks Dr
Salisbury, NC 28147-8183
Phone (704) 636-0271

7482 Waterside Crossing Blvd
Suite 103
Denver, NC 28037-3006
Phone (704) 827-0598

Hospital & facility affiliations

  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
149274NCMDInternal Medicine Physician
2011-01206NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tryon Medical Partners, PLLC Internal Medicine CurrentSince Sep 1, 2018 Accepting new patients

Locations

10635 Park Rd
Ste I
Charlotte, NC 28210
Phone (704) 495-6025

6060 Piedmont Row Dr S
Fl 7
Charlotte, NC 28287
Phone (704) 489-3094

9615 Kincey Ave
Ste 210
Huntersville, NC 28078
Phone (704) 489-3113

Interoperability endpoints

  • Direct secure messaging: jenifer.ingle.1@17847.direct.athenahealth.com

Organizations & group practices 1

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 1

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": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1124293881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S COLLEGE ST",
            "address_2": "STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022067",
            "telephone_number": "704-302-8800",
            "fax_number": "704-632-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S COLLEGE ST",
            "address_2": "SUITE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022012",
            "telephone_number": "704-302-8800",
            "fax_number": "704-632-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGLE",
        "first_name": "JENIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "149274",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2011-01206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918984",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124293881",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC1488",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.