Individual provider Active NPI

Kristen Ingram, MD

  • Family Medicine Physician
  • Salem, IN
National Provider Identifier
1689626038
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01060058A Issued in IN
Practice address
1002 N Shelby St Ste 1004
Salem, IN 47167
Phone
(812) 883-9182
NPI assigned
May 16, 2006
Last updated
Jun 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01060058A IN Primary

Addresses

Primary practice location

1002 N Shelby St Ste 1004
Salem, IN 47167

Mailing address

1002 N Shelby St Ste 1004
Salem, IN 47167-2307

Other identifiers 1

IdentifierTypeStateIssuer
200275770MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kristen.ingram.1@7598.direct.athenahealth.com St. Vincent Medical Group, Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051025000769 IN Practitioner - Family Practice 2163449562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

1002 N Shelby St
Salem, IN 47167-2307

250 W 96TH St
Suite 520
Indianapolis, IN 46260-1317

8433 Harcourt Rd
Suite 100
Indianapolis, IN 46260-2193
Phone (317) 583-7600

911 N Shelby St
Salem, IN 47167-2304
Phone (812) 883-5881

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. Family Medicine CurrentSince Jul 1, 2012 Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Jul 1, 2012 Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients

Locations

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

642 W Hospital Rd
Paoli, IN 47454
Phone (812) 723-2811

1002 N Shelby St
Ste 1000
Salem, IN 47167
Phone (812) 833-3627

1002 N Shelby St
Ste 1003
Salem, IN 47167
Phone (812) 883-9182

1002 N Shelby St
Ste 1004
Salem, IN 47167
Phone (812) 883-9182

Interoperability endpoints

  • Direct secure messaging: kristen.ingram.1@7598.direct.athenahealth.com

Organizations & group practices 3

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 3

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1689626038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N SHELBY ST STE 1004",
            "city": "SALEM",
            "state": "IN",
            "postal_code": "471672307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N SHELBY ST STE 1004",
            "city": "SALEM",
            "state": "IN",
            "postal_code": "47167",
            "telephone_number": "812-883-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "KRISTEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01060058A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200275770",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristen.ingram.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "1002 N Shelby St Ste 1004",
            "city": "Salem",
            "state": "IN",
            "country_code": "US",
            "postal_code": "47167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salem, IN

Sources for this page

Verify at the official NPI Registry.