Individual provider Active NPI

Grant Ingram, M.ED, BCBA

  • Behavior Analyst
  • San Angelo, TX
National Provider Identifier
1740619444
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-13-14897 Issued in TX
Practice address
2032 W Harris Ave
San Angelo, TX 76901-3806
Phone
(325) 320-3204
NPI assigned
Nov 4, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-13-14897 TX Primary

Addresses

Primary practice location

2032 W Harris Ave
San Angelo, TX 76901-3806

Mailing address

6026 Winners Cir
San Angelo, TX 76904-9368
Phone (325) 320-3204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education

Practice roles

OrganizationSpecialtyStatusNew patients
West Texas Child Development Center Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1740619444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6026 WINNERS CIR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769049368",
            "telephone_number": "325-320-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2032 W HARRIS AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769013806",
            "telephone_number": "325-320-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "GRANT",
        "credential": "M.ED, BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-13-14897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; 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.