Allyson Michelle Ingram, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9473 Issued in GA

Practice address

462 Elma G Miles Pkwy Ste 102a
Hinesville, GA 31313-4000

Phone

(912) 369-9310

Fax

(912) 877-3102

NPI assigned

May 13, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Allyson Michelle Eurek Former name

Medicare fee-for-service enrollment

Enrolled in NC, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Urgent Care LLCGroup PAC ID 4082802509, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Southern Urgent Care LLC

  • Urgent Care Clinic/Center
  • Savannah, GA
  • NPI 1205136470
  Medicare reassignment Care Compare group
• Southland Optim Jenkins Emergency Medical Services, LLC

  • Emergency Medicine Physician
  • Millen, GA
  • NPI 1265826242
  Medicare reassignment
• Goldsboro Emergency Medical Specialists, Inc.

  • Emergency Medicine Physician
  • Goldsboro, NC
  • NPI 1164418232
  Medicare reassignment
• Southland Optim Jenkins Emergency Medical Services, LLC

  dba DBA Southland Liberty Emergency Medical Services

  • Emergency Medicine Physician
  • Hinesville, GA
  • NPI 1477913580
  NPD

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1972959492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX K",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275339710",
            "telephone_number": "919-580-0004",
            "fax_number": "919-580-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 ELMA G MILES PKWY STE 102A",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134000",
            "telephone_number": "912-369-9310",
            "fax_number": "912-877-3102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Wayne Memorial Dr",
            "address_2": "Emergency Dept",
            "address_purpose": "LOCATION",
            "city": "Goldsboro",
            "state": "NC",
            "postal_code": "275349494",
            "country_code": "US",
            "telephone_number": "919-731-6060",
            "fax_number": "919-731-6534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "ALLYSON",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-13",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001006436",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC MEDICAL LICENSE",
            "identifier": "0010-06436",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLYSON",
            "last_name": "EUREK",
            "middle_name": "MICHELLE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Benjamin Thomas Ivey III, PT, DPT
• Erika Latavia Jackson, BCABA

• Physician Assistant in Hinesville, GA
• Providers in Hinesville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.