JONATHAN INGRAM PMHNP
NPI 1336557867
Nurse Practitioner - Psychiatric/Mental Health in Moses Lake, WA

Q: What is Jonathan Ingram's NPI number?

The NPI number for Jonathan Ingram is 1336557867. It was assigned to this individual provider in the NPPES registry on July 28, 2014.

Q: What is Jonathan Ingram's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Jonathan Ingram was last updated on May 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 28, 2014PECOS EnrolledAccepts Medicare Assignment

1550 S PIONEER WAY STE 165, MOSES LAKE, WA 98837(509) 793-9780(509) 764-3246 Get Directions Write a Review

NPPES record last updated: May 4, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 4, 2026, Mar 19, 2021, Apr 1, 2020 and 1 more (4 updates tracked since 2019).

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About Jonathan Ingram Pmhnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JONATHAN INGRAM PMHNP (NPI 1336557867) is an individual psychiatric/mental health provider in Moses Lake, Washington, licensed in Washington (AP60491883) and active in the NPI registry since July 2014. He is enrolled in Medicare PECOS, is affiliated with Samaritan Hospital, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1336557867

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameJONATHAN INGRAMCredential: PMHNP

Location Address1550 S PIONEER WAY STE 165Moses Lake, WA 98837-4637

Mailing Address1616 S Pioneer WayMoses Lake, WA 98837-2487 · (509) 793-9715 · Fax (509) 764-3244

Phone(509) 793-9780

Fax(509) 764-3246

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateJuly 28, 2014

Last NPPES UpdateMay 4, 20264 updates tracked since enumeration

NPPES CertifiedMay 4, 2026

✔ NPI 1336557867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in WA · AP60491883

1550 S PIONEER WAY STE 165, Moses Lake, WA 98837

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Other Identifiers 1

Medicaid2038198WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jonathan Ingram Pmhnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1355568528

PECOS Enrollment IDI20140812000842

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Samaritan Hospital

Acute Care Hospitals · Moses Lake, WA

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number500033

Location801 East Wheeler RoadMoses Lake, WA 98837 · Grant County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98837 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$100.78 typical visit price

range $18.56 – $141.11

Typical copayment $25.19 (range $4.64 – $35.27)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

IGNACIO FABIAN GONZALES MS

Counselor (Mental Health)