Nanette Marilyn Ingram, CLC, MLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

330626 Issued in VA

Practice address

5907 Montpelier Dr
Williamsburg, VA 23188-8122

Phone

(951) 905-8209

NPI assigned

Jan 22, 2024

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Undefined Non-Physician Type (Specify)

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Full Tummies Lactation, LLC

  • Specialist
  • Williamsburg, VA
  • NPI 1992675326
  NPD Authorized official

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1508627035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5907 MONTPELIER DR",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231888122",
            "telephone_number": "951-905-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5907 MONTPELIER DR",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231888122",
            "telephone_number": "951-905-8209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "732 Thimble Shoals Blvd Ste 603",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064257",
            "country_code": "US",
            "telephone_number": "951-905-8209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "NANETTE",
        "middle_name": "MARILYN",
        "name_prefix": "Mrs.",
        "credential": "CLC, MLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "330626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Awais Ilyas, SURGICAL ASSISTANT
• Virginia Impelido-Dayoan, MSW
• Independence Child Therapy Services
• Independence Psychotherapy Services LLC
• Andrew Ingell, DPT
• Inner Balance Services LLC
• Institute for Psychological & Health Development
• Integrated Therapy, PLLC
• Integrative Medicine Center, PLLC
• Integrity Healthcare Corporation

• Specialist in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.