Individual provider Active NPI

Kathy M Ingelse, PMHNP, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bend, OR
National Provider Identifier
1437248481
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
200950048NP Issued in OR
Practice address
2577 NE Courtney Dr
Bend, OR 97701-7638
Phone
(541) 322-7500
Fax
(541) 322-7565
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 200350026NP OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 200950048NP OR Primary

Addresses

Primary practice location

2577 NE Courtney Dr
Bend, OR 97701-7638

Mailing address

65880 93Rd St
Bend, OR 97701-8960
Phone (541) 318-7527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
200950048NPORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deschutes County Oregon Current Accepting new patients
Mosaic Community Health CurrentSince Mar 1, 2017 Accepting new patients
Mosaic Medical Dental PastSince Mar 1, 2017 Accepting new patients

Locations

2577 NE Courtney Dr
Bend, OR 97701
Phone (541) 322-7400

600 SW Columbia St
Ste 6210
Bend, OR 97702

375 NW Beaver St
Ste 101
Prineville, OR 97754
Phone (541) 316-6026

Organizations & group practices 3

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.

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": "1383868800000",
    "number": "1437248481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65880 93RD ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977018960",
            "telephone_number": "541-318-7527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2577 NE COURTNEY DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017638",
            "telephone_number": "541-322-7500",
            "fax_number": "541-322-7565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGELSE",
        "first_name": "KATHY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PMHNP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200350026NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "200950048NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.