Antonio Denard Ingram, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP136580 Issued in TX

Practice address

2600 Central Fwy Ste 180
Wichita Falls, TX 76306-2850

Phone

(940) 257-0000

NPI assigned

Jul 10, 2012

Reactivated

Jul 1, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• DHHS PHS Naihs Crownpoint Hospital

  • General Acute Care Hospital
  • Crownpoint, NM
  • NPI 1114960093

  TX

  Medicare reassignment NPD
• Beacon Integrated Healthcare

  • Family Nurse Practitioner
  • De Kalb, TX
  • NPI 1164176749
  NPD Authorized official
• Ingram Health Consulting

  • Primary Care Clinic/Center
  • De Kalb, TX
  • NPI 1023632619
  NPD (past) Authorized official
• Pueblo Pintado Clinic

  • Clinic/Center
  • Cuba, NM
  • NPI 1023051133
  NPD
• Thoreau Clinic

  • Clinic/Center
  • Thoreau, NM
  • NPI 1679516702
  NPD

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1144585761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 CENTRAL FWY STE 180",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763062850",
            "telephone_number": "940-257-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 CENTRAL FWY STE 180",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763062850",
            "telephone_number": "940-257-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "ANTONIO",
        "middle_name": "DENARD",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-10",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "deactivation_date": "2020-05-10",
        "reactivation_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "769058",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP136580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ray H Hyde IX, D.D.S.
• Mustafa Nayeem Hyder, M.D
• Icw Ta
• Sulaiman Iftikhar, MD
• Ejikeme Igwilo
• Injury One of Wichita Falls, LLC
• Integracare of Wichita Falls, LLC
• Integrated Management Solutions, Inc
• Integrated Pharmacy, LLC
• Internal Medicine Associates

• Family Nurse Practitioner in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.