Ralph N Ingram, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C4289 Issued in AR

Practice address

5111 Rogers Ave
Ste 40M
Fort Smith, AR 72903-2047

Phone

(479) 709-7440

Fax

(479) 709-7441

NPI assigned

Oct 6, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2017 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Sparks Medical Foundation

  • Family Medicine Physician
  • Fort Smith, AR
  • NPI 1932204369
  NPD (past)

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221436800000",
    "number": "1366430126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1824",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729021824",
            "telephone_number": "479-709-7399",
            "fax_number": "479-709-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 ROGERS AVE",
            "address_2": "STE 40M",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032047",
            "telephone_number": "479-709-7440",
            "fax_number": "479-709-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "RALPH",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2008-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C4289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105589001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100073480A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tabasum Imran, MD
• Imwell Health
• Infectious Diseases Services of Arkansas
• Infectious Diseases Services of Arkansas LLC
• Karen S Infield, LPC
• Kennith Inklebarger
• Inner Peace Wellness Center Inc.
• Institute for the Creative Arts
• Institute for the Creative Arts
• Internally Bloom LLC

• Family Medicine Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.