Active NPI
Sofia G Ingeman
- Optician
- Kingman, AZ
National Provider Identifier
1881463297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- LDO-002595
- Practice address
- 3396 N Stockton Hill Rd
Kingman, AZ 86409-3648 - Phone
- (928) 681-3533
- NPI assigned
- Dec 27, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | LDO-002595 | AZ | Primary |
Addresses
Primary practice location
3396 N Stockton Hill Rd
Kingman, AZ 86409-3648
Mailing address
PO Box 54
Chloride, AZ 86431-0054
Phone (928) 565-1035
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LDO-002595 | AZ | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1703635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703635200000",
"number": "1881463297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 54",
"city": "CHLORIDE",
"state": "AZ",
"postal_code": "864310054",
"telephone_number": "928-565-1035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3396 N STOCKTON HILL RD",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864093648",
"telephone_number": "928-681-3533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGEMAN",
"first_name": "SOFIA",
"middle_name": "G",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-12-27",
"last_updated": "2023-12-27",
"certification_date": "2023-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "AZ",
"license": "LDO-002595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingman, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.