Individual provider Active NPI

Jessica A. Ingram, MNT

  • Renal Nutrition Registered Dietitian
  • Philadelphia, PA
National Provider Identifier
1639142250
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Renal Nutrition Registered DietitianTaxonomy code 133VN1005X
License
DN000551 Issued in PA
Practice address
1 Penn Blvd.
Suite 2240
Philadelphia, PA 19144
Phone
(215) 991-9440
Fax
(215) 849-2975
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Nutrition Registered Dietitian 133VN1005X DN000551 PA Primary

Addresses

Primary practice location

1 Penn Blvd.
Suite 2240
Philadelphia, PA 19144

Mailing address

1 Penn Blvd.
Suite 2240
Philadelphia, PA 19144
Phone (215) 991-9440

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Valley Nephrology and Hypertension Assoc PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1639142250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PENN BLVD.",
            "address_2": "SUITE 2240",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19144",
            "telephone_number": "215-991-9440",
            "fax_number": "215-849-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PENN BLVD.",
            "address_2": "SUITE 2240",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19144",
            "telephone_number": "215-991-9440",
            "fax_number": "215-849-2975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "JESSICA",
        "middle_name": "A.",
        "credential": "MNT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "PA",
            "license": "DN000551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.