Ingrid W Jackson MD Inc. P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

15786 Issued in OK

Legal business name

INGRID W JACKSON MD INC. P.C.

Practice address

13321 N Meridian Ave
Ste 314
Oklahoma City, OK 73120-8356

Phone

(405) 470-7189

Fax

(405) 470-7712

NPI assigned

May 26, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Ingrid Worrell Jackson, M.D.NPI 1265492417

Title

Owner/President

Phone

(405) 473-7927

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Ingrid Worrell Jackson, MD

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1265492417
  NPD (past) Authorized official
• Kenneth Washington, PA-C

  • Medical Physician Assistant
  • Oklahoma City, OK
  • NPI 1548471857
  NPD (past)

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243296000000",
    "number": "1396970976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6957 NW EXPRESSWAY # 254",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731323533",
            "telephone_number": "405-473-7927",
            "fax_number": "405-470-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13321 N MERIDIAN AVE",
            "address_2": "STE 314",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208356",
            "telephone_number": "405-470-7189",
            "fax_number": "405-470-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGRID W JACKSON MD INC. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-26",
        "last_updated": "2009-05-26",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "INGRID",
        "authorized_official_middle_name": "WORRELL",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "405-473-7927",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "15786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100220060B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacklyn M Ingram, M.ED
• Kacie Marie Ingram, CTRS/L
• Kaysi Ingram
• Kristyn B. Ingram, MD
• Reuben Julius Ingram, CBT
• Trevor Ink, PSY.D.
• Hannah Inks
• Lisa Inman
• Juyoung Samuel Inn, MD
• Inner Life Counseling

• Family Medicine Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; 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.