Active NPI
Robert Jefferson Ingram, BA
- Case Manager/Care Coordinator
- Knoxville, TN
National Provider Identifier
1508906918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 2018 Western Ave
Knoxville, TN 37921-5718 - Phone
- (865) 544-0406
- Fax
- (865) 544-0480
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
2018 Western Ave
Knoxville, TN 37921-5718
Mailing address
6350 W a J Hwy
Department 100
Talbott, TN 37877
Phone (800) 355-3565
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
- Credentials
- Bachelor of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289865600000",
"number": "1508906918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6350 W A J HWY",
"address_2": "DEPARTMENT 100",
"city": "TALBOTT",
"state": "TN",
"postal_code": "37877",
"telephone_number": "800-355-3565",
"fax_number": "423-714-2355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2018 WESTERN AVE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379215718",
"telephone_number": "865-544-0406",
"fax_number": "865-544-0480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGRAM",
"first_name": "ROBERT",
"middle_name": "JEFFERSON",
"credential": "BA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2010-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.