J KEVIN INGRAM MEDICAL, INC
NPI 1871761619
Family Medicine in Vidalia, LA
About J Kevin Ingram Medical, Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
J KEVIN INGRAM MEDICAL, INC (NPI 1871761619) is a healthcare organization registered as a family medicine in Vidalia, Louisiana and active in the NPI registry since February 2008. The organization holds a CLIA Waiver certificate valid through August 17, 2028 and lists Johnny Kevin Ingram, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
J Kevin Ingram Medical, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to J Kevin Ingram Medical, Inc, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 19D1088143
J Kevin Ingram Medical · Vidalia, LAFrequently 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 J Kevin Ingram Medical, Inc's NPI number?
The NPI number for J Kevin Ingram Medical, Inc is 1871761619. It was assigned to this organization in the NPPES registry on February 14, 2008.
Where is J Kevin Ingram Medical, Inc located?
J Kevin Ingram Medical, Inc is located at 1806 Carter St, Vidalia, LA 71373. The listed phone number is (318) 757-6526.
What is J Kevin Ingram Medical, Inc's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is J Kevin Ingram Medical, Inc enrolled in Medicare?
Yes. J Kevin Ingram Medical, Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through J Kevin Ingram Medical, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to J Kevin Ingram Medical, Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does J Kevin Ingram Medical, Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 19D1088143) is associated with this NPI, valid through August 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does J Kevin Ingram Medical, Inc accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee list J Kevin Ingram Medical, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for J Kevin Ingram Medical, Inc was last updated on June 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.
# J Kevin Ingram Medical, Inc · NPI 1871761619
Family Medicine organization in Vidalia, Louisiana. Organization record, active in the CMS NPPES registry since February 14, 2008.
## Identity
- **NPI:** 1871761619 (Entity type: Organization)
- **Enumerated:** February 14, 2008
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Johnny Ingram, OWNER
## Practice location
- **Address:** 1806 CARTER ST, Vidalia, LA 71373-3115
- **Phone:** (318) 757-6526
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 12, 2008
- **Other identifiers:** Medicare PIN 5DC61 (LA); Medicare UPIN I53108 (LA); Medicare PIN 4K134DC61 (LA); and 1 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1871761619) · Data from the CMS NPPES public registry.