Active NPI
Malcolm Lewis Ingram, PTA
- Physical Therapy Assistant
- Lenexa, KS
National Provider Identifier
1588976278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2005014828
- Practice address
- 8855 Gallery St
Lenexa, KS 66215-3285 - Phone
- (913) 549-3084
- NPI assigned
- Jul 9, 2010
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2005014828 | MO | Primary |
| Physical Therapy Assistant | 225200000X | 1401738 | KS |
Addresses
Primary practice location
8855 Gallery St
Lenexa, KS 66215-3285
Mailing address
8855 Gallery St
Lenexa, KS 66215-3285
Phone (913) 549-3084
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 |
|---|---|---|---|
| 1401738 | KS | MD | Physical Therapy Assistant |
| 2005014828 | MO | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278633600000",
"number": "1588976278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8855 GALLERY ST",
"city": "LENEXA",
"state": "KS",
"postal_code": "662153285",
"telephone_number": "913-549-3084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8855 GALLERY ST",
"city": "LENEXA",
"state": "KS",
"postal_code": "662153285",
"telephone_number": "913-549-3084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGRAM",
"first_name": "MALCOLM",
"middle_name": "LEWIS",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-09",
"last_updated": "2010-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MO",
"license": "2005014828",
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KS",
"license": "1401738",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lenexa, KS
- Icare Transportation LLC
- Im Consulting, LLC
- Impact Therapy LLC
- Independent Orthopaedics and Sports Medicine P.C.
- Infinite Healthcare Services, LLC
- Insight Vision Center
- Institute for Advanced Bariatric Surgery, Inc
- Integrative Health Providers LLC
- Integrity Chiropractic and Wellness, LLC
- Interactive Therapies LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.