Brandy E. Ingram, P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3713 Issued in AZ

Practice address

5030 S Mill Ave Ste D12
D12
Tempe, AZ 85282-6849

Phone

(480) 894-2823

Fax

(480) 756-6663

NPI assigned

Jan 25, 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 2

Medicare fee-for-service enrollment

Enrolled in AZ

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Clean Colonic LLC

  • Durable Medical Equipment & Medical Supplies
  • Tempe, AZ
  • NPI 1609226364
  NPD (past)

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1730366386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 S MILL AVE STE D12",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852826849",
            "telephone_number": "480-894-2823",
            "fax_number": "480-756-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 S MILL AVE STE D12",
            "address_2": "D12",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852826849",
            "telephone_number": "480-894-2823",
            "fax_number": "480-756-6663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "BRANDY",
        "middle_name": "E.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-25",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1079446",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "356769",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Infinite Potential Chiropractic, LLC
• Infinity Health Solutions LLC
• Infinity Life Home Care
• Infinity Spine Center PLLC
• Bethan Ingham
• Kelly Ingram, SLP
• Injury Pain Group, LLC
• Inland Empire Mental Health Services
• Inner-Work Counseling
• Leslie Sue Innis, PHYSICAL THERAPIST

• Medical Physician Assistant in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.