Individual provider Active NPI

Stephanie Taylor Ingersoll, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1124448022
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
743706 Issued in TX
Practice address
6606 LBJ Fwy Ste 200
Dallas, TX 75240-6524
Phone
(972) 715-5000
Fax
(972) 715-9976
NPI assigned
Apr 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 743706 TX Primary

Addresses

Primary practice location

6606 LBJ Fwy Ste 200
Dallas, TX 75240-6524

Mailing address

PO Box 650865
Dallas, TX 75265-0865
Phone (972) 715-5000

Other practice location 1

910 E Houston St Ste 400
Tyler, TX 75702-8368
Phone (903) 606-4268

Other practice location 2

1720 S Beckham Ave Ste 104
Tyler, TX 75701-4437
Phone (903) 606-3900

Other practice location 3

8389 S Broadway Ave
Tyler, TX 75703-5408
Phone (903) 606-6500

Other practice location 4

800 E Dawson St
Tyler, TX 75701-2036
Phone (903) 606-4500

Other identifiers 2

IdentifierTypeStateIssuer
341115903MedicaidTX
8550UJOtherTXBCBS TX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140628000025 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 3870718141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mother Frances Hospital Regional Health Care CenterGroup PAC ID 9234025636, 120 clinicians

Practice addresses (Care Compare)

800 E Dawson St
Tyler, TX 75701-2036

910 E Houston St
Christus Mother Frances Hospital
Tyler, TX 75702-8369
Phone (903) 531-5300

Hospital & facility affiliations

  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
743706TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mother Frances Hospital Regional Health Care Center CurrentSince Jan 16, 2024 Accepting new patients
Trinity Clinic Past Accepting new patients
Dallas Anesthesia & Pain Medicine Specialists LLP Past Accepting new patients
Anesthesia Consultants of Dallas LLP Past Accepting new patients

Locations

910 E Houston St
Ste 400
Tyler, TX 75702
Phone (903) 531-4268

8389 S Broadway Ave
Tyler, TX 75703
Phone (903) 606-4129

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

1720 S Beckham Ave
Ste 104
Tyler, TX 75701
Phone (903) 597-2002

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1124448022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650865",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650865",
            "telephone_number": "972-715-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6606 LBJ FWY STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406524",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 E Houston St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757028368",
            "country_code": "US",
            "telephone_number": "903-606-4268",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1720 S Beckham Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757014437",
            "country_code": "US",
            "telephone_number": "903-606-3900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8389 S Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757035408",
            "country_code": "US",
            "telephone_number": "903-606-6500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 E Dawson St",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012036",
            "country_code": "US",
            "telephone_number": "903-606-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INGERSOLL",
        "first_name": "STEPHANIE",
        "middle_name": "TAYLOR",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-18",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "743706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341115903",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "8550UJ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.