Kyle Ingram, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

579 Issued in OR

Practice address

470 NE Stephens St
Suite 102
Roseburg, OR 97470-3158

Phone

(541) 673-5770

Fax

(541) 673-5774

NPI assigned

Jan 4, 2010

Sex

Male

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

Enrolled in OR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Therapeutic Services LLC

  • Rehabilitation Clinic/Center
  • Roseburg, OR
  • NPI 1336479971
  Medicare reassignment NPD

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

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1336479989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 NE STEPHENS ST",
            "address_2": "SUITE 102",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703158",
            "telephone_number": "541-673-5770",
            "fax_number": "541-673-5774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 NE STEPHENS ST",
            "address_2": "SUITE 102",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703158",
            "telephone_number": "541-673-5770",
            "fax_number": "541-673-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "KYLE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-04",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Icco, LLC
• Icco, LLC
• Arielle Illia
• In-8, LLC
• Denise Ingeman, RN
• Integrated Chiropractic and Rehab PC
• Integricare, Inc.
• Integricare, Inc.
• Internal Medicine & Geriatrics, P.C.
• Irc-Renasolve Roseburg Joint Venture LLC

• Occupational Therapist in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Occupational Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.