Matthew Kyle Ingram, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

001097 Issued in IA

Practice address

32 E Main St
Marshalltown, IA 50158-4903

Phone

(641) 753-6636

NPI assigned

Jan 17, 2017

Last updated

Jan 17, 2017By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Sportsplus Physical Therapy GC LLC

  • Physical Therapy Clinic/Center
  • Grundy Center, IA
  • NPI 1790140234
  NPD (past)
• Sportsplus Sports Medicine and Physical Therapy Center Inc

  • Physical Therapy Clinic/Center
  • Marshalltown, IA
  • NPI 1467422014
  NPD (past)

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1811433600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2612 RIDGE RD",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501589549",
            "telephone_number": "641-691-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 E MAIN ST",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501584903",
            "telephone_number": "641-753-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "MATTHEW",
        "middle_name": "KYLE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "001097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hy-Vee Inc (Hy-Vee Pharmacy (1403))
• Brooke Ashton Ibeling
• Faiza Ahmed Ibrahim
• Kayla Illingworth, OTR/L
• In Perspective, PLLC.
• Inman Chiropractic Clinic Inc
• Brittany Inman, BA
• Timothy John Inman
• Iowa Dermatology Clinic PLC (Radiant Complexions Dermatology Clinics or Radiant Pathology)
• Iowa Dermatology Clinic, PLC (Radiant Complexions Dermatology Clinic)

• Athletic Trainer in Marshalltown, IA
• Providers in Marshalltown, IA by specialty
• Athletic Trainer in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.