NPIMap

Individual provider Active NPI

Brian E. Ingalls, MD

  • Family Medicine Physician
  • Johnson City, TN
National Provider Identifier
1477584654
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD21725 Issued in TN
Practice address
917 W Walnut St
Johnson City, TN 37604-6527
Phone
(423) 439-6464
Fax
(423) 439-7118
NPI assigned
Jul 5, 2006
Last updated
Mar 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD021725 TN
Family Medicine Physician 207Q00000X MD21725 TN Primary

Addresses

Primary practice location

917 W Walnut St
Johnson City, TN 37604-6527

Mailing address

PO Box 699
Mountain Home, TN 37684-0699
Phone (423) 439-6464

Other identifiers 1

IdentifierTypeStateIssuer
000735424BMedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070921000514 TN Practitioner - Emergency Medicine 2769576685 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

917 W Walnut St
Johnson City, TN 37604-6527
Phone (423) 439-6464

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD021725TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Afc Physicians of Tennessee, PC Current Accepting new patients
Chattanooga Emergency Medicine PLLC CurrentSince Jul 1, 2007 Accepting new patients
Medical Education Assistance Corporation Family Medicine CurrentSince Mar 1, 2020 Accepting new patients
Afc Physicians of Tennessee, PC CurrentSince Apr 14, 2018 Accepting new patients
Chattanooga Emergency Medicine PLLC CurrentSince Mar 20, 2022 Accepting new patients
Afc Physicians of Tennessee, PC Family Medicine CurrentSince Apr 14, 2018 Accepting new patients
Emergency Medical Associates Past Accepting new patients
Mountain States Health Alliance Past Accepting new patients
Emergency Medical Associates Past Accepting new patients

Locations

2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620

3520 Cummings Hwy
Chattanooga, TN 37419
Phone (205) 745-4291

725 Glenwood Dr
Ste E487
Chattanooga, TN 37404
Phone (423) 697-0014

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

917 W Walnut St
Johnson City, TN 37604
Phone (423) 439-6464

6606 Charlotte Pike
Ste 104
Nashville, TN 37209
Phone (615) 630-6095

Organizations & group practices 9

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1477584654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-439-6464",
            "fax_number": "423-439-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 W WALNUT ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046527",
            "telephone_number": "423-439-6464",
            "fax_number": "423-439-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGALLS",
        "first_name": "BRIAN",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "MD021725",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD21725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000735424B",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.