Individual provider Active NPI

Joel Ingram

  • Physical Therapist
  • Cresco, IA
National Provider Identifier
1831607019
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
235 8TH Ave W
Cresco, IA 52136-1062
Phone
(563) 547-6361
NPI assigned
Jan 22, 2018
Last updated
Mar 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

235 8TH Ave W
Cresco, IA 52136-1062

Mailing address

850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180607002116 IA Practitioner - Physical Therapist in Private Practice 0446515704 Reassigns benefits to 2 organizations
I20240126004051 MN Practitioner - Physical Therapist in Private Practice 0446515704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stadia Sports Medicine PCGroup PAC ID 4284647579, 3 clinicians

Practice addresses (Care Compare)

7601 Office Plaza Dr N
Suite 140
West Des Moines, IA 50266-1207
Phone (515) 221-1102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13372MNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Activept Corp CurrentSince Jan 12, 2024 Accepting new patients
Stadia Sports Medicine PC Physical Therapist CurrentSince Mar 27, 2025 Accepting new patients
Pursuitpt LLC Physical Therapist PastSince Mar 7, 2021 Accepting new patients
Ora Orthopedics, PC Past Accepting new patients

Locations

6000 University Ave
West Des Moines, IA 50266
Phone (515) 241-2100

6000 University Ave
Ste 250
West Des Moines, IA 50266
Phone (515) 221-1102

7601 Office Plaza Dr N
Ste 140
West Des Moines, IA 50266
Phone (515) 221-1102

3100 19th St NW
Ste 200
Rochester, MN 55901

4229 W Frontage Rd N
Rochester, MN 55901

Organizations & group practices 5

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": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1831607019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 43RD AVE STE 100",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612658401",
            "telephone_number": "309-743-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 8TH AVE W",
            "city": "CRESCO",
            "state": "IA",
            "postal_code": "521361062",
            "telephone_number": "563-547-6361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "JOEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-22",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cresco, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.