Active NPI
Denise Ingram
- Phlebotomy Technician
- McDonough, GA
National Provider Identifier
1922809755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- License
- L4Q4H2W4
- Practice address
- 2086 Jodeco Rd # 1284
McDonough, GA 30253-5220 - Phone
- (470) 715-4542
- NPI assigned
- Mar 19, 2025
- 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 |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | L4Q4H2W4 | GA | Primary |
Addresses
Primary practice location
2086 Jodeco Rd # 1284
McDonough, GA 30253-5220
Mailing address
2086 Jodeco Rd # 1284
McDonough, GA 30253-5220
Phone (470) 715-4542
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 |
|---|---|---|---|
| L4Q4H2W4 | GA | MD | Phlebotomy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742342400000",
"number": "1922809755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2086 JODECO RD # 1284",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302535220",
"telephone_number": "470-715-4542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2086 JODECO RD # 1284",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302535220",
"telephone_number": "470-715-4542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGRAM",
"first_name": "DENISE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-03-19",
"last_updated": "2025-03-19",
"certification_date": "2025-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "GA",
"license": "L4Q4H2W4",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McDonough, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.