DR. ANDREW BRADFORD INGRAHAM (NPI# 1841642642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841642642 |
| Entity Type | Individual |
| Full Name | DR. ANDREW BRADFORD INGRAHAM |
| Credential | M.D. |
| Practice Address |
2600 Kiley Way Plymouth WI 53073-5020 |
| Mailing Address |
3301 W Forest Home Ave Milwaukee WI 53215-2843 |
| Practice Telephone | 9204497000 |
| Mailing Telephone | 4143892233 |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2020-07-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | MD-45463 | IA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 73536 | WI | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | R-10753 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100100690 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1201 3rd Ave Se, Cedar Rapids, IA 524034009 | 3197307300 | 3197307368 |
| Street Address |
2600 KILEY WAY |
| City | PLYMOUTH |
| State | WI |
| Zip Code | 53073-5020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770558264 | Mauricio E Palencia | Emergency Medicine | 2600 Kiley Way, Plymouth, WI 53073-5020 | 2006-02-20 |
| 1962016790 | Daniel Myron Lapean | Massage Therapist | 2600 Kiley Way, Plymouth, WI 53073-5020 | 2020-08-31 |
| 1669003463 | Mitchell Adams | Pharmacist | 2600 Kiley Way, Plymouth, WI 53073-5020 | 2020-01-30 |
| 1457911455 | April L Okruszynski | Physical Therapist | 2600 Kiley Way, Plymouth, WI 53073-5020 | 2019-06-20 |
| 1235621228 | Andrea S Seifert | Physical Therapist | 2600 Kiley Way, Plymouth, WI 53073-5020 | 2018-06-05 |
| 1740797851 | Dena Horvath | Nurse Practitioner | 2600 Kiley Way, Plymouth, WI 53073-5020 | 2018-01-10 |
| 1922528710 | Bethany L Graesslin | Physical Therapist | 2600 Kiley Way, Plymouth, WI 53073-5020 | 2017-06-22 |
| 1760911721 | Katie E Thompson | Internal Medicine | 2600 Kiley Way, Plymouth, WI 53073-5020 | 2017-06-05 |
| 1003347451 | Anthony Lazaro | Family Medicine | 2600 Kiley Way, Plymouth, WI 53073-5020 | 2017-03-27 |
| 1063822575 | Liya Milgram | Family Medicine | 2600 Kiley Way, Plymouth, WI 53073 | 2014-05-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245889914 | Patricia M. Stone | Technician | 440 Stoneybrook Lane, Plymouth, WI 53073 | 2019-09-05 |
| 1801387501 | Kwon Yang | Dentist | W 9071 Forest Drive, Plymouth, WI 53073 | 2018-05-29 |
| 1396258752 | Advanced Dental Care Clinic Sc | Clinic/Center | 62 S Pleasant View Road, Plymouth, WI 53073 | 2017-11-08 |
| 1164888004 | Lukresse Tatiana Kouam Tchuendem | Registered Nurse | 236 N Milwaukee St, Plymoth, WI 53073 | 2016-01-07 |
| 1831447424 | Lori Ann Schuette | Registered Nurse | 406 Summit Street, Plymouth, WI 53073 | 2012-08-29 |
| 1821360967 | Kristine Marie Van Ess | Case Manager/Care Coordinator | 7135 Rocky Knoll Pkwy, Plymouth, WI 53073 | 2012-02-06 |
| 1750699708 | Shannon Diamond | Physical Therapist | 825 Walton Drive, Plymouth, WI 53073 | 2010-09-23 |
| 1306088265 | Lacey Lyn Schafer | Nurse Practitioner | W9071 Forest Dr, Plymouth, WI 53073 | 2009-03-24 |
| 1275780868 | Stella D. Kaas-lallensack | Occupational Therapist | W5774 Garton Rd, Plymouth, WI 53073 | 2008-08-26 |
| 1912172248 | Judith A Nelson | Registered Nurse | N7116 County Road E, Plymouth, WI 53073 | 2008-04-28 |
| Find all providers in zip 53073 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265996219 | Housecall Physicians, Inc | Family Medicine | 31 Home Depot Drive, Suite 283, Plymouth, MA 02360 | 2019-01-24 |
| 1215445994 | Jefferson Community Health Center Inc | Family Medicine | 316 N Madison Ave, Ste 200, Plymouth, NE 68424-4110 | 2018-01-17 |
| 1124551833 | Xpress Urgent Care PC | Family Medicine | 49237 Fox Dr N, Plymouth, MI 48170-5205 | 2017-04-10 |
| 1952853525 | Ann Curoe | Family Medicine | 10835 38th Pl N, Plymouth, MN 55441-1409 | 2016-10-31 |
| 1639429558 | Carol Elizabeth Ness | Family Medicine | 1145 Shenandoah Ln N, Plymouth, MN 55447-3201 | 2012-09-18 |
| 1881953461 | Ronald Carl Skoogberg | Family Medicine | 3025 Harbor Lane, Suite 101, Plymouth, MN 55447-5141 | 2012-05-16 |
| 1093955700 | Soliman Home Visiting Physicians Pllc | Family Medicine | 12173 Chandler Dr, Plymouth, MI 48170-3193 | 2009-02-20 |
| 1457508079 | Chaitra Channappa | Family Medicine | 31 Home Depot Dr Ste 283, Plymouth, MA 02360-2669 | 2008-08-26 |
| 1730365388 | Milton Delin Westberg | Family Medicine | 1010 Wilson St, Plymouth, NC 27962-9185 | 2008-01-14 |
| 1194849398 | Michael A Martella | Family Medicine | 515 E Mill Street, Plymouth, WI 53073-1807 | 2007-03-16 |
| Find all providers in PLYMOUTH | ||||
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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.