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RUSSELL LEON INGRAM M.D.
NPI 1639163397
Family Medicine in Jacksonville, AL

Active since September 08, 2005PECOS Enrolled
1460 2ND AVE SW, JACKSONVILLE, AL 36265(256) 435-2180(256) 435-9525 Get Directions Write a Review

NPPES record last updated: July 26, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Russell Leon Ingram M.d. NPPES

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

RUSSELL LEON INGRAM M.D. (NPI 1639163397) is an individual family medicine provider in Jacksonville, Alabama, licensed in Alabama (7858) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639163397
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameRUSSELL LEON INGRAMCredential: M.D.
Location Address1460 2ND AVE SWJacksonville, AL 36265-3358
Mailing Address1460 2nd Ave SwJacksonville, AL 36265-3358 · (256) 435-2180 · Fax (256) 435-9525
Phone(256) 435-2180
Fax(256) 435-9525
Sole ProprietorYes
Enumeration DateSeptember 8, 2005
Last NPPES UpdateJuly 26, 2007
✔ NPI 1639163397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in AL · 7858
Definition

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.

1460 2ND AVE SW, Jacksonville, AL 36265
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Other Identifiers 3

Medicare ID-Type Unspecified51519662AL
Other51519662AL · Blue Cross Blue Shield
Medicare UPINC72397AL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Russell Leon Ingram M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36265 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
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
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.

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
9 suppliers31 claims90 services$6.15 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
3 suppliers11 claims17 services$1.21 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier11 claims11 services$15.94 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers15 claims15 services$93.64 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
2 suppliers15 claims15 services$22.62 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier11 claims11 services$207.48 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

JACKSONVILLE SURGICAL & MEDICAL AFFILIATES, LLC
Clinic/Center
1460 2ND AVE SW
JACKSONVILLE, AL 36265
Calhoun County (256) 782-4395
DR MUHAMAD MAZEN FESTOK
Clinic/Center
1460 2ND AVE SW, B
JACKSONVILLE, AL 36265
Calhoun County (256) 435-5325
JAMES RICHARD YATES M.D.
Internal Medicine
1460 2ND AVE SW
JACKSONVILLE, AL 36265
Calhoun County (256) 435-2180

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Russell Ingram's NPI number?

The NPI number for Russell Ingram is 1639163397. It was assigned to this individual provider in the NPPES registry on September 8, 2005.

Where is Russell Ingram located?

Russell Ingram practices at 1460 2nd Ave SW, Jacksonville, AL 36265. The listed phone number is (256) 435-2180.

What is Russell Ingram's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Russell Ingram enrolled in Medicare?

Yes. Russell Ingram is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Russell Ingram was last updated on July 26, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.