Active NPI
Jamie Ingram, PTA
- Physical Therapy Assistant
- Worcester, MA
National Provider Identifier
1972857522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 8644
- Practice address
- 484 Main St
Worcester, MA 01608-1893 - Phone
- (508) 751-6322
- NPI assigned
- Nov 5, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 8644 | MA | Primary |
Addresses
Primary practice location
484 Main St
Worcester, MA 01608-1893
Mailing address
69 Warren Ave Unit 3
Woburn, MA 01801-4948
Phone (704) 942-7478
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 |
|---|---|---|---|
| 8644 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352073600000",
"number": "1972857522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "69 WARREN AVE UNIT 3",
"city": "WOBURN",
"state": "MA",
"postal_code": "018014948",
"telephone_number": "704-942-7478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "484 MAIN ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016081893",
"telephone_number": "508-751-6322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGRAM",
"first_name": "JAMIE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-05",
"last_updated": "2012-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "8644",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.