Shaun Ingram

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

25901 Issued in TN

Practice address

4250 Faronia Rd Ste 4
Memphis, TN 38116-6527

Phone

(901) 348-9600

NPI assigned

Jun 28, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innovista Provider Group Texas PAGroup PAC ID 6901235423, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: singram25661@innovista.gardenplot.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Innovista Provider Group Texas PA

  • Family Medicine Physician
  • Houston, TX
  • NPI 1780231928
  Medicare reassignment Care Compare group NPD
• Innovista Provider Group Texas PA

  • Family Medicine Physician
  • Spring, TX
  • NPI 1427603901
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1093377194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 FARONIA RD STE 4",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381166527",
            "telephone_number": "901-348-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 FARONIA RD STE 4",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381166527",
            "telephone_number": "901-348-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "SHAUN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-28",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "25901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Inglis, LCSW
• Anna Westling Ingram
• Charles C Ingram, MD
• Hannah Dawson Ingram, FNP-C
• Nina Ingram
• Sherry Lynn Ingram, PHARMD
• Injury Medical Center of Memphis
• Joel S Inman, CRNA
• Nicholas Jordan Inman, MD
• Vladyslava Inman, DNP

• Family Nurse Practitioner in Memphis, TN
• Providers in Memphis, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.