Kyle Ingram, OTR
Occupational Therapist in Roseburg, OR. Individual provider (NPI-1).
NPI number1336479989
StatusActive
Last updated in NPPESNov 1, 2016
Details
- NPI
- 1336479989
- Entity type
- Individual (NPI-1)
- Name
- Kyle Ingram
- Credential
- OTR
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 4, 2010
- Last updated
- Nov 1, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | 579 | OR | Yes |
Practice location
470 Ne Stephens StSuite 102
Roseburg, OR 97470-3158
Phone 541-673-5770 · Fax 541-673-5774
Mailing address
470 Ne Stephens StSuite 102
Roseburg, OR 97470-3158
Phone 541-673-5770 · Fax 541-673-5774
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 16 Occupational Therapist providers in Roseburg · All 2,380 providers in Roseburg
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