Yvette M Ingram, PHD, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT001325A Issued in PA

Practice address

115 Willis Health Professions Building
Lock Haven University
Lock Haven, PA 17745-1212

Phone

(570) 660-0738

NPI assigned

Jun 16, 2006

Sex

Female

Sole proprietor

No

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

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1295779221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 WILLIS HEALTH PROFESSIONS BUILDING",
            "address_2": "LOCK HAVEN UNIVERSITY",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "177451212",
            "telephone_number": "570-660-0738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WILLIS HEALTH PROFESSIONS BUILDING",
            "address_2": "LOCK HAVEN UNIVERSITY",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "177451212",
            "telephone_number": "570-660-0738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "YVETTE",
        "middle_name": "M",
        "credential": "PHD, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT001325A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Lock Haven, PA
• Providers in Lock Haven, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; 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.