Active NPI
Dennis Alan Ingram, STATE LICENSED OPTIC
- Optician
- Parker, AZ
National Provider Identifier
1194938373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 1140
- Practice address
- 1317 Joshua Ave
Suite H
Parker, AZ 85344 - Phone
- (928) 669-6971
- Fax
- (928) 669-8901
- NPI assigned
- May 7, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 1140 | AZ | Primary |
Addresses
Primary practice location
1317 Joshua Ave
Suite H
Parker, AZ 85344
Mailing address
828 Crystal View Dr
Parker, AZ 85344
Phone (928) 667-3153
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 |
|---|---|---|---|
| 1140 | AZ | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Somerton Eyecare Center Inc | Past | Accepting new patients | |
| Parker Optical | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Eyewear Supplier
- Parker, AZ
- NPI 1366620734
-
- Optometrist
- Somerton, AZ
- NPI 1306981386
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194938373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "828 CRYSTAL VIEW DR",
"city": "PARKER",
"state": "AZ",
"postal_code": "85344",
"telephone_number": "928-667-3153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1317 JOSHUA AVE",
"address_2": "SUITE H",
"city": "PARKER",
"state": "AZ",
"postal_code": "85344",
"telephone_number": "928-669-6971",
"fax_number": "928-669-8901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGRAM",
"first_name": "DENNIS",
"middle_name": "ALAN",
"credential": "STATE LICENSED OPTIC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "AZ",
"license": "1140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Parker, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.