Brian R Ingram, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2018-0050 Issued in NM

Practice address

1851 Old Hwy 66
Edgewood, NM 87015

Phone

(505) 286-2396

Fax

(505) 286-2398

NPI assigned

Aug 30, 2018

Last updated

Aug 30, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

H2 Rehabilitation Services of Virginia, LLCGroup PAC ID 1658280128, shared by 6 NPIs, 67 clinicians

Ignite Wellness Clinic PLLCGroup PAC ID 8022404623, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Roanoke, VA, CCN 497429
• Carilion Home Care Services - Roanoke Home health agency, Roanoke, VA, CCN 497258
• Carilion Medical Center Hospital, Roanoke, VA, CCN 490024
• Lewisgale Medical Center Hospital, Salem, VA, CCN 490048

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Ignite Wellness Clinic PLLC

  • Orthopaedic Surgery Physician
  • Roanoke, VA
  • NPI 1871244103
  Medicare reassignment Care Compare group
• Synergy Surgicalists LLC

  • Orthopaedic Surgery Physician
  • North Dartmouth, MA
  • NPI 1114334422
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carilion Medical Center

  dba Carilion Roanoke Memorial Hospital

  • General Acute Care Hospital
  • Roanoke, VA
  • NPI 1033102942
  Care Compare affiliation
• Carilion Medical Center

  dba Carilion Clinic Home Health

  • Home Health Agency
  • Roanoke, VA
  • NPI 1073506002
  Care Compare affiliation
• Centerwell Certified Healthcare Corp.

  dba CenterWell Home Health

  • Home Health Agency
  • Roanoke, VA
  • NPI 1124059688
  Care Compare affiliation
• Lewis-Gale Medical Center, LLC

  dba Lewisgale Medical Center

  • General Acute Care Hospital
  • Salem, VA
  • NPI 1619914785
  Care Compare affiliation

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1700368495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12127B HWY 14 N STE 5",
            "city": "CEDAR CREST",
            "state": "NM",
            "postal_code": "870089499",
            "telephone_number": "505-281-5180",
            "fax_number": "505-281-5320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 OLD HWY 66",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "87015",
            "telephone_number": "505-286-2396",
            "fax_number": "505-286-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "BRIAN",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2018-0050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Hentz
• Ryan Hotchkiss, PT
• House Calls to You
• Tracey Hughes, LMT, NTS
• Yourah Hwang, CNP
• Dennis W. Jackson, D.D.S.
• Melissa D Jackson, DMD
• Darcie Jepsen, LMSW
• Serina Johnson
• Paula A Jones-Irvin, P.T.

• Physician Assistant in Edgewood, NM
• Providers in Edgewood, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.