Active NPI
Dorothy Ingram
- Massage Therapist
- Bristol, CT
National Provider Identifier
1619334133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 004073
- Practice address
- 1001 Farmington Ave
Bristol, CT 06010-3990 - Phone
- (860) 582-8024
- Fax
- (860) 585-0609
- NPI assigned
- Jan 28, 2016
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 004073 | CT | Primary |
Addresses
Primary practice location
1001 Farmington Ave
Bristol, CT 06010-3990
Mailing address
61 High St
Terryville, CT 06786-5413
Phone (860) 202-7828
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 |
|---|---|---|---|
| 004073 | CT | MD | Oral and Maxillofacial Pathology Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1619334133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "61 HIGH ST",
"city": "TERRYVILLE",
"state": "CT",
"postal_code": "067865413",
"telephone_number": "860-202-7828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 FARMINGTON AVE",
"city": "BRISTOL",
"state": "CT",
"postal_code": "060103990",
"telephone_number": "860-582-8024",
"fax_number": "860-585-0609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGRAM",
"first_name": "DOROTHY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-28",
"last_updated": "2023-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CT",
"license": "004073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bristol, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.