Mary Mi'Shon Ingram, RN, NP-BC

Key facts

NPI

1558042804

Entity type

Individual (NPI type 1)

Primary specialty

Primary Care Nurse Practitioner 363LP2300X

License

RN274291 (GA)

Practice address

713 20TH St
Columbus, GA 31904-8920

Phone

(706) 660-5080

NPI assigned

Jul 28, 2023

Sex

Female

Sole proprietor

Yes

Organizations & group practices 8

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.

• Phoebe Putney Memorial Hospital Inc General Acute Care Hospital · Albany, GA · NPI 1992789721
  Medicare reassignment Care Compare group NPD GA · SINGLE SPECIALTY
• Phoebe Putney Memorial Hospital Inc Community/Retail Pharmacy · Albany, GA · NPI 1891315420
  Care Compare group NPD
• Phoebe Putney Memorial Hospital Inc Home Health Agency · Albany, GA · NPI 1790766863
  Care Compare group
• Phoebe Putney Memorial Hospital, Inc. Rehabilitation Hospital Unit · Albany, GA · NPI 1316992027
  Care Compare group
• Phoebe Putney Memorial Hospital, Inc. Psychiatric Hospital Unit · Albany, GA · NPI 1669438404
  Care Compare group
• Phoebe Putney Memorial Hospital, Inc. Rural Health Clinic/Center · Camilla, GA · NPI 1821293788
  Care Compare group
• Phoebe Putney Memorial Hospital, Inc. Community Based Hospice Care Agency · Albany, GA · NPI 1851356349
  Care Compare group
• Phoebe Putney Memorial Hospital, Inc. Durable Medical Equipment & Medical Supplies · Albany, GA · NPI 1871697508
  Care Compare group

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Phoebe Putney Memorial Hospital Inc General Acute Care Hospital · Albany, GA · NPI 1992789721
  Care Compare affiliation Hospital
• Phoebe Sumter Medical Center, Inc. General Acute Care Hospital · Americus, GA · NPI 1609001312
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoebe Putney Memorial Hospital, Inc. (75 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phoebe Putney Memorial Hospital Hospital · Albany, GA · CCN 110007
• Phoebe Sumter Medical Center Hospital · Americus, GA · CCN 110044

Medicare participation

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 28, 2023.

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1558042804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 W CHURCH ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093510",
            "telephone_number": "229-815-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 20TH ST",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319048920",
            "telephone_number": "706-660-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "MARY",
        "middle_name": "MI'SHON",
        "credential": "RN, NP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN274291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

• Ashley Ingram, LPC
• Benjie Tyrone Ingram
• Joshua Ingram
• Kimberly Charon Ingram, RN
• Ku'Wonna Ingram
• Michelle Ingram
• Initium Vitae
• Injoy Counseling and Consulting Services LLC
• Inmotion Sports Performance and Rehabilitation, LLC.
• Innovate Healthcare Inc

All providers in Columbus, GA · Primary Care Nurse Practitioner in Georgia