Individual provider Active NPI

Kathleen Ingellis

  • Family Nurse Practitioner
  • Springvale, ME
National Provider Identifier
1306583182
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP221094 Issued in ME
Practice address
15 Oak St
Springvale, ME 04083-1926
Phone
(207) 490-6900
Fax
(207) 459-2822
NPI assigned
May 13, 2022
Last updated
Jun 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP221094 ME
Student in an Organized Health Care Education/Training Program 390200000X
Family Nurse Practitioner 363LF0000X CNP221094 ME Primary

Addresses

Primary practice location

15 Oak St
Springvale, ME 04083-1926

Mailing address

91 Auburn St
Ste J #1180
Portland, ME 04103-2119
Phone (203) 577-9660

Other practice location 1

400 Congress St
Portland, ME 04101-3515
Phone (323) 205-7088

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220826000168 ME Practitioner - Nurse Practitioner 8325422231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15 Oak St
Springvale, ME 04083-1926
Phone (207) 490-6900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
York County Community Action Corp CurrentSince Aug 19, 2024 Accepting new patients

Locations

357 Elm St
Biddeford, ME 04005
Phone (207) 282-5919

15 Oak St
Springvale, ME 04083
Phone (207) 490-6900

Interoperability endpoints

  • Direct secure messaging: kathleen.ingellis.p1@direct.nassonhealthcare.nextgenshare.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1306583182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 AUBURN ST",
            "address_2": "STE J #1180",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032119",
            "telephone_number": "203-577-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 OAK ST",
            "city": "SPRINGVALE",
            "state": "ME",
            "postal_code": "040831926",
            "telephone_number": "207-490-6900",
            "fax_number": "207-459-2822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Congress St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041013515",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INGELLIS",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-13",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP221094",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP221094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springvale, ME

Sources for this page

Verify at the official NPI Registry.