Active NPI
Jermila Ingram
- Pharmacist
- Douglasville, GA
National Provider Identifier
1477164101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH031695
- Practice address
- 3687 Highway 5
Douglasville, GA 30135-2385 - Phone
- (770) 577-8979
- NPI assigned
- Aug 15, 2020
- Last updated
- Dec 18, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH031695 | GA | Primary |
Addresses
Primary practice location
3687 Highway 5
Douglasville, GA 30135-2385
Mailing address
3687 Highway 5
Douglasville, GA 30135-2385
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH031695 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671321600000",
"number": "1477164101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3687 HIGHWAY 5",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301352385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3687 HIGHWAY 5",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301352385",
"telephone_number": "770-577-8979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGRAM",
"first_name": "JERMILA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-15",
"last_updated": "2022-12-18",
"certification_date": "2022-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH031695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
- Infinite & Endless Possibilities, LLC.
- Infocus Eye Care, Inc. (Arbor Place Eye Care)
- Informed Group Enterprises
- Informed Group Enterprises LLC
- Ingles Markets Inc (Ingles Pharmacy #414)
- Inner Harbour, LTD.
- Insight Psychological Solutions LLC
- Inspire Innovate Heal LLC
- Inspiring Healing and Hope Counseling and Development Center, LLC
- Integrated Counseling Center & Consulting Services, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.