DR. JORDAN B INGRAM (M.D.) – Emergency Medicine Physician, NPI 1679952535

DR. JORDAN B INGRAM (M.D.) is a healthcare provider. based in West plains, Missouri. specializing in INTERNAL MEDICINE, FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. 57323 (TN). The NPI Number for DR. JORDAN B INGRAM (M.D.) is 1679952535

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
DR. JORDAN B INGRAM (M.D.)
NPI
1679952535
Phone
(417) 256-9111
Address
1100 N Kentucky Ave
Enumeration Date
26 May 2015
Last Update Date
25 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6624461072
Graduation Year
2015 (11 years ago)
PAC ID
1153620885
Group Practice PAC ID
5698102465
Professional Enrollment ID
I20180725000141
Address ID
MS393392772LO17550STXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:11State licenses:3Digital endpointsOther names

4,190 INTERNAL MEDICINE in MO

Provider Addresses for DR. JORDAN B INGRAM (M.D.)

  • 1100 N Kentucky Ave

    West Plains, MO 657752029

    Phone: (417) 256-9111

    Type: Location

  • 950 MATTHEW DR

    WAYNESBORO, MS 393672590

    Phone: (601) 735-5151

    Fax: (601) 735-7169

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-07-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 4 Medicare enrollment records; no due dates published yet.

Enrollment records

4

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180724001176IFamily PracticeTNTBD
I20180725000141IFamily PracticeMSTBD
I20231213003660IInternal MedicineMOTBD
I20240718002825IEmergency MedicineLATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99284Emergency department visit with moderate level of medical decision making149140$0
99285Emergency department visit with high level of medical decision making10198$0
99283Emergency department visit with low level of medical decision making8281$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only6561$0
99291Critical care, first 30-74 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 65775)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5698102465View full group profile
NameSpecialtyState
Emergency MedicineTX
Family PracticeMS
Family PracticeMS
-MD
Emergency MedicineLA
Internal Medicine, Emergency MedicineMS
Family Practice, Emergency MedicineMS
Osteopathic Manipulative Medicine, Emergency MedicineMS
-MS
Emergency MedicineMS

Reviews

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Frequently asked questions

What unique ID ties claims to DR. JORDAN B INGRAM (M.D.)?
NPI 1679952535 is assigned to DR. JORDAN B INGRAM (M.D.) under the national enumeration system.
Is DR. JORDAN B INGRAM (M.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is DR. JORDAN B INGRAM (M.D.)?
The page reflects Emergency Medicine Physician for DR. JORDAN B INGRAM (M.D.). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. JORDAN B INGRAM (M.D.)?
The page summarizes West Plains, Missouri for DR. JORDAN B INGRAM (M.D.); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.