Ingram Comprehensive Eye Care PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

1320 Issued in SC

Legal business name

INGRAM COMPREHENSIVE EYE CARE PA

Practice address

4406A Forest Dr
Columbia, SC 29206-3129

Phone

(803) 782-7080

Fax

(803) 744-0964

NPI assigned

Jun 28, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Benjamin D Ingram, ODNPI 1356301485

Title

Owner and Ceo

Phone

(803) 782-7080

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benjamin Derrick Ingram, OD

  • Optometrist
  • Columbia, SC
  • NPI 1356301485
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396942876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4406A FOREST DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292063129",
            "telephone_number": "803-782-7080",
            "fax_number": "803-744-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4406A FOREST DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292063129",
            "telephone_number": "803-782-7080",
            "fax_number": "803-744-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGRAM COMPREHENSIVE EYE CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER AND CEO",
        "authorized_official_telephone_number": "803-782-7080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D13206",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Individual
• Infinite Solutions Counseling and Consulting LLC
• Infinity Diabetic & Medical Supply
• Stephanie S Inglett
• Tavanette Ingraham
• Michelle Ingram-Smith
• Benjamin Derrick Ingram, OD
• Byron Ingram, D.O.
• Corey Ingram, LMSW
• Emily Foreman Ingram

• Optometrist in Columbia, SC
• Providers in Columbia, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.