Shirley Blaine Ingram, M.D.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

MD12875 Issued in OR

Practice address

3181 SW Sam Jackson Park Rd
Ohsu Div Arthritis and Rheum Dis Op09
Portland, OR 97239-3011

Phone

(503) 494-8637

Fax

(503) 494-1022

NPI assigned

Jan 14, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1700062353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "OHSU DIV ARTHRITIS AND RHEUM DIS OP09",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8637",
            "fax_number": "503-494-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "OHSU DIV ARTHRITIS AND RHEUM DIS OP09",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8637",
            "fax_number": "503-494-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "SHIRLEY",
        "middle_name": "BLAINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-14",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "OR",
            "license": "MD12875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285056",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariela Ingoglia
• Ian Ingram, PHARMD
• Kenneth Dale Ingram, PA
• Kyle Ingram, PHARM.D.
• Nina Ingram
• Hugo Bernard Ings, CADC II
• Gemma A Inguanta, MSW
• Inhabit Therapy, LLC
• Soledad Grefnes Iniguez, WHCNP
• Kalpana Rejina Injety, D.O.

• Rheumatology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Rheumatology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.