Stephanie Ingram, CSA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

3135 Issued in GA

Practice address

863 Flat Shoals Rd SE Ste C238
Conyers, GA 30094-6633

Phone

(770) 354-6940

NPI assigned

Apr 16, 2008

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Sgi Surgical Care Incorporated

  • Surgical Physician Assistant
  • Conyers, GA
  • NPI 1215306295
  NPD Authorized official
• Sgi Surgical LLC

  • Surgical Physician Assistant
  • Covington, GA
  • NPI 1972822062
  NPD (past) Authorized official

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1154595676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "863 FLAT SHOALS RD SE STE C238",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946633",
            "telephone_number": "770-354-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "863 FLAT SHOALS RD SE STE C238",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946633",
            "telephone_number": "770-354-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "STEPHANIE",
        "credential": "CSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "3135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Infinite Care at Home LLC
• Ingles Markets Inc
• Malinda Ingram Weeks, LPC, NCC
• Anna Cunningham Ingram, LPC
• Kacey Ingram, RN
• Innovative Nursing Solutions and Hospice Care LLC
• Innovative Nursing Solutions of Georgia LLC
• Instant Labs and Testing Center
• Integrity Complex Care Management, LLC
• Integrity Staffing

• Surgical Physician Assistant in Conyers, GA
• Providers in Conyers, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.