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Deactivated NPI 1659322188 Deactivated / Inactive NPI Male Practitioner

Brian Grant Ingram , PA

Physician Assistant • Jackson, MI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Brian Ingram has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 12, 2006
NPI Deactivation Date March 03, 2022
Total Practice Duration ~16 Years of Practice (2006 – 2022)

Professional Overview & Biography Verified Profile Summary

Brian Ingram, PA was a registered Physician Assistant practicing in Jackson, MI. Throughout an active medical career spanning 16 years, Brian Ingram provided care at the practice location at 205 N EAST AVE until profile deactivation on 2022-03-03.

Historical Medicare Part B clinical services included established patient outpatient office visit, new patient outpatient office visit, automated urinalysis test. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

205 N East Ave

Jackson, MI 492011753

Telephone 5177884996
Fax 5177966410
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Jackson, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 11.8 Yrs
State Avg: 12.2 Yrs
Regional Practice Density
104 Specialists

Practicing in Jackson, MI (7057 Statewide)

Telehealth Adoption Rate
3.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
43.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2018)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
67 61 $150.00 $88.72
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
59 59 $225.00 $136.18
81003 Automated urinalysis test
16 16 $25.00 $2.71

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License MI 5601002700

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

17 Associated Practitioners
Dr. Jonathan Bradley , MD

Emergency Medicine

NPI 1063463552

Doctor of Medicine (M.D.)

Dr. Deepa Macha , MD

Emergency Medicine

NPI 1134121684

Doctor of Medicine (M.D.)

Dr. David Farhat , MD

Emergency Medicine

NPI 1285690230

Doctor of Medicine (M.D.)

Holly Paul , NP

Nurse Practitioner

NPI 1295786630

Nurse Practitioner

Dr. Amir Mujeeb , MD

Internal Medicine

NPI 1447280458

Doctor of Medicine (M.D.)

Dr. David Remmler , MD

Emergency Medicine

NPI 1548226624

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 03, 2022

Record deactivated on March 03, 2022

NPI Profile Active November 23, 2007

NPI status registered as active in NPPES database

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Updated Practice Location November 23, 2007

Registered at 205 N EAST AVE, JACKSON, MI 492011753 (Tel: 5177884996)

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Updated Business Mailing Address November 23, 2007

Registered at DEPARTMENT 272801, PO BOX 67000, DETROIT, MI 482672728 (Tel: 5178416913)

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Provider Name / Credentials Updated November 23, 2007

Recorded as BRIAN INGRAM, PA

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 23, 2007

Physician Assistant (License #5601002700 in MI)

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Initial NPI Registration & Enumeration May 12, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1659322188
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 12, 2006
Last Update: November 23, 2007
Deactivation Date: March 03, 2022

Mailing Address

Department 272801, Po Box 67000

Detroit, MI 482672728

Phone: 5178416913

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.