Dustin Al Ingram, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

137096 Issued in GA

Practice address

705 Dixie St
Carrollton, GA 30117-3818

Phone

(770) 812-9666

NPI assigned

May 31, 2022

Sex

Male

Sole proprietor

Yes

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 GA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

TMC-West Georgia Anesthesia Associates Inc.Group PAC ID 2365456308, 67 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011
• Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015

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.

• TMC-West Georgia Anesthesia Associates Inc.

  • Anesthesiology Physician
  • Carrollton, GA
  • NPI 1740252022

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tanner Medical Center, Inc

  • General Acute Care Hospital
  • Carrollton, GA
  • NPI 1801883780
  Care Compare affiliation
• TMC/Villa Rica Hospital, Inc

  • General Acute Care Hospital
  • Villa Rica, GA
  • NPI 1851388748
  Care Compare affiliation

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1346989142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 DOGWOOD DR",
            "city": "OXFORD",
            "state": "AL",
            "postal_code": "362032714",
            "telephone_number": "256-454-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 DIXIE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173818",
            "telephone_number": "770-812-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "DUSTIN",
        "middle_name": "AL",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "137096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert S Hyslop, M.D.
• Icare of West Georgia
• Toni Janell Idiaquez, LAC
• Independent Physical Therapy of Ga, LLC
• Ingles Markets Inc
• James Thomas Ingram, MD
• Insight Psychiatric Services, Inc
• Integrative Body Health, PC
• Interventional Spine and Pain Management Center, PC
• William Curtis Irby, M.D.

• Certified Registered Nurse Anesthetist in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Certified Registered Nurse Anesthetist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.