Jacqueline Ingram, CRNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

1-139311 Issued in AL

Practice address

22 Inverness Center Pkwy Ste 350
Hoover, AL 35242-4820

Phone

(866) 686-2504

NPI assigned

Feb 2, 2024

Last updated

Feb 2, 2024By the provider in NPPES

Sex

Female

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

Locations

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.

• Optum Medical Services, PC

  dba Aor

  • Nurse Practitioner
  • Eden Prairie, MN
  • NPI 1144769241
  NPD

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1962265850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 BROADLEAF WAY",
            "city": "MIDLAND CITY",
            "state": "AL",
            "postal_code": "363507104",
            "telephone_number": "334-790-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 INVERNESS CENTER PKWY STE 350",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352424820",
            "telephone_number": "866-686-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "JACQUELINE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AL",
            "license": "1-139311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vitalii Iakovliev, MD
• Amy L Illescas, M.D.
• Imedex
• Inclusive Psychotherapy LLC
• Dawson Ryan Ingram
• Caitlin Jessica Inman, LICSW, PIP
• Innovex Diagnostic Solutions LLC
• Inspire Counseling, LLC
• Integrative Chiropractic, LLC
• Intentional Healing, LLC

• Primary Care Nurse Practitioner in Hoover, AL
• Providers in Hoover, AL by specialty
• Primary Care Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.