Individual provider Active NPI

Terri L Ingram, MD

  • Neuroradiology Physician
  • Denver, CO
National Provider Identifier
1215948062
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
30853 Issued in CO
Practice address
938 Bannock St
Ste 300
Denver, CO 80204-4028
Phone
(303) 914-8800
Fax
(303) 716-3777
NPI assigned
Aug 10, 2006
Last updated
May 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 30853 CO Primary

Addresses

Primary practice location

938 Bannock St
Ste 300
Denver, CO 80204-4028

Mailing address

938 Bannock St
Ste 300
Denver, CO 80204-4028
Phone (303) 914-8800

Other practice location 1

10350 E Dakota Ave
Denver, CO 80247-1314
Phone (303) 338-4545

Other identifiers 2

IdentifierTypeStateIssuer
01308535MedicaidCO
008551OtherCOKAISER COMMERCIAL NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20031126000420 CO Practitioner - Diagnostic Radiology 3375447758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Virginia Commonwealth University, School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Permanente Medical Group PCGroup PAC ID 1254238454, 1,325 clinicians

Practice addresses (Care Compare)

2045 N Franklin St
Kaiser Permanente Franklin Medical
Denver, CO 80205-5437
Phone (303) 338-4545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30853COMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Colorado CurrentSince Oct 19, 2009 Accepting new patients
Colorado Permanente Medical Group, P.C. CurrentSince Oct 19, 2009 Accepting new patients
Flatirons Radiology, LLC Neuroradiology Past Accepting new patients

Locations

10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350

1501 S Potomac St
Denver, CO 80012
Phone (303) 695-2604

2045 N Franklin St
Denver, CO 80205
Phone (303) 764-4666

4567 E 9th Ave
Denver, CO 80220
Phone (303) 302-2121

200 Exempla Cir
Lafayette, CO 80026
Phone (303) 689-4110

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1215948062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "938 BANNOCK ST",
            "address_2": "STE 300",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044028",
            "telephone_number": "303-914-8800",
            "fax_number": "303-716-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "938 BANNOCK ST",
            "address_2": "STE 300",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044028",
            "telephone_number": "303-914-8800",
            "fax_number": "303-716-3777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10350 E Dakota Ave",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802471314",
            "country_code": "US",
            "telephone_number": "303-338-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "TERRI",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CO",
            "license": "30853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01308535",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "008551",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "CAREQUALITY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10350 E Dakota Ave",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802471314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.