Samuel Aaron Ingram, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11-04512 Issued in KS

Practice address

7105 Mission Rd
Prairie Village, KS 66208-3077

Phone

(913) 262-1611

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidd-Krafft Occupational and Physical Therapy PAGroup PAC ID 1254689169, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Tidd-Krafft Occupational and Physical Therapy PA

  dba Powerback Rehabilitation

  • Physical Therapist
  • Overland Park, KS
  • NPI 1225541246
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1710009733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12411 W 119TH TER APT 618",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662135725",
            "telephone_number": "817-269-5971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7105 MISSION RD",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662083077",
            "telephone_number": "913-262-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "SAMUEL",
        "middle_name": "AARON",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1166119",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-04512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Hunt, DC
• Hunter Family Vision, PA (Hunter Family Vision)
• Hy-Vee Inc (Hy-Vee Pharmacy (1532))
• I Can Therapy LLC
• Impact Orthopedics & Sports Medicine, LLC
• Taylor Ivie-Mott
• Merri Patience Jacobs, COTA
• Jaime Duke LLC
• Brandon Allen James, DDS
• Rachael James, APRN, PMHNP

• Physical Therapist in Prairie Village, KS
• Providers in Prairie Village, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.