Individual provider Active NPI

Ingrid Patricia Pearson, MS RN CPNP

  • Pediatric Nurse Practitioner
  • Batesburg, SC
National Provider Identifier
1407945355
Registry record updated Mar 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1003 Issued in SC
Practice address
120 W Church St
Batesburg, SC 29006-2107
Phone
(803) 532-2208
Fax
(803) 604-0207
NPI assigned
Oct 11, 2006
Last updated
Mar 7, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1003 SC Primary

Addresses

Primary practice location

120 W Church St
Batesburg, SC 29006-2107

Mailing address

120 W Church St
Batesburg-Leesville, SC 29006-2107
Phone (803) 532-2208

Other identifiers 1

IdentifierTypeStateIssuer
NP0181MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner, Master of Science, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
1003SCMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299456000000",
    "number": "1407945355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W CHURCH ST",
            "city": "BATESBURG-LEESVILLE",
            "state": "SC",
            "postal_code": "290062107",
            "telephone_number": "803-532-2208",
            "fax_number": "803-604-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W CHURCH ST",
            "city": "BATESBURG",
            "state": "SC",
            "postal_code": "290062107",
            "telephone_number": "803-532-2208",
            "fax_number": "803-604-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "INGRID",
        "middle_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "MS RN CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2011-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "1003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0181",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; 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.