Active NPI
Andrea Brook Ingram, M.S. CCC-SLP
- Speech-Language Pathologist
- Springdale, AR
National Provider Identifier
1275705279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP#1930
- Practice address
- 3955 East Monitor Rd
Springdale, AR 72764-7430 - Phone
- (479) 750-8749
- NPI assigned
- Mar 31, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP#1930 | AR | Primary |
Addresses
Primary practice location
3955 East Monitor Rd
Springdale, AR 72764-7430
Mailing address
674 Buckhead Ave
Springdale, AR 72764-7430
Phone (479) 750-8749
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP#1930 | AR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206921600000",
"number": "1275705279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "674 BUCKHEAD AVE",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727647430",
"telephone_number": "479-750-8749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3955 EAST MONITOR RD",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727647430",
"telephone_number": "479-750-8749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGRAM",
"first_name": "ANDREA",
"middle_name": "BROOK",
"name_prefix": "Mrs.",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-31",
"last_updated": "2008-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "SP#1930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.