DR. JOHN BRADFORD INGRAM (NPI# 1134319619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134319619 |
| Entity Type | Individual |
| Full Name | DR. JOHN BRADFORD INGRAM |
| Credential | M.D. |
| Practice Address |
2500 N State St Jackson MS 39216-4500 |
| Practice Telephone | 6019845211 |
| Mailing Telephone | 6019845211 |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2014-02-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 20177 | MS | Allopathic & Osteopathic Physicians |
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
20177 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08888868 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386021939 | John M Ingram Jr. | Perfusionist | 9632 Nw 7th Cir, Apt 1718, Plantation, FL 33324-7533 | 2015-05-04 |
| 1962811455 | John M Ingram | Chore Provider | 1047 Burns Ave, Wyoming, OH 45215-2795 | 2014-08-08 |
| 1851674618 | John Kenneth Ingram | Pharmacist | 9591 Conners Rd, Villa Rica, GA 30180 | 2011-09-27 |
| 1053480996 | John J Ingram IIi | Internal Medicine | 266 Joule St, Alcoa, TN 37701-2422 | 2006-11-07 |
| 1447366711 | John E. Ingram | Urology | 2888 Long Beach Blvd, Suite 340, Long Beach, CA 90806-1530 | 2006-08-21 |
| 1205838984 | John D. Ingram | Family Medicine | 2016 1st Ave S, Denison, IA 51442-2210 | 2005-08-12 |
| Street Address |
2500 N STATE ST |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556231 | University Ophthalmology Associates | Ophthalmology | 2500 N State St, Ste B329, Jackson, MS 39216-4500 | 2005-05-24 |
| 1396346607 | Ashleigh Renfroe Hannah | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-11-03 |
| 1770182438 | Tara P. Carter | Nurse Practitioner | 2500 N State St, Jackson, MS 39216-4500 | 2020-10-22 |
| 1679189849 | Raegan Wilson | Registered Nurse | 2500 N State St, Jackson, MS 39216-4500 | 2020-09-22 |
| 1851905095 | Violet Maloba Awori | Student in an Organized Health Care Education/Training Program | 2500 N State St, Jackson, MS 39216-4500 | 2020-09-04 |
| 1295348639 | Kassidy Voinche | Pharmacist | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-25 |
| 1215549423 | Brittney Leeann Williams | Pharmacist | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-19 |
| 1912519364 | Rashmi Verma | Internal Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-18 |
| 1982215414 | Anita Dhanrajani | Pediatrics | 2500 N State St, Jackson, MS 39216-4500 | 2020-08-10 |
| 1528676954 | Nicholas Mcafee | Psychologist | 2500 N State St, Jackson, MS 39216-4500 | 2020-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417213836 | Ashley Nicole Stanley-copeland | Psychiatry & Neurology | 2500 N State St, Jackson, MS 39216-4500 | 2012-04-10 |
| 1003006206 | Lamar Davis II | Psychiatry & Neurology | 2500 N State St, Jackson, MS 39216 | 2007-07-25 |
| 1609929470 | Upa Pllc Neurology | Psychiatry & Neurology | 2500 N State St, Jackson, MS 39216-4500 | 2007-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386147874 | Richard John Gorman Md | Psychiatry & Neurology | 1903 Pass Rd Ste A, Biloxi, MS 39531-4103 | 2018-03-12 |
| 1033521513 | Varun Sreenivasan | Psychiatry & Neurology | 7730 Old Canton Rd Bldg A, Madison, MS 39110-9299 | 2014-06-02 |
| 1972720175 | Anderson Regional Medical Center | Psychiatry & Neurology | 2124 14th St, Meridian, MS 39301 | 2007-04-19 |
| 1366562431 | Richard John Gorman | Psychiatry & Neurology | 1903 Pass Rd Ste A, Biloxi, MS 39531-4103 | 2007-03-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.