Individual provider Active NPI

Victoria Elizabeth Inghram, MCN, RD, LD

  • Registered Dietitian
  • Lewisville, TX
National Provider Identifier
1568124865
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86117376 Issued in TX
Practice address
105 Kathryn Dr Ste D
Lewisville, TX 75067-4200
Phone
(800) 972-0643
Fax
(214) 279-5032
NPI assigned
Oct 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86117376 TX Primary

Addresses

Primary practice location

105 Kathryn Dr Ste D
Lewisville, TX 75067-4200

Mailing address

4251 FM 2181 Ste 230-517
Corinth, TX 76210-4219
Phone (800) 972-0643

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220318001745 TX Practitioner - Registered Dietitian Or Nutrition Professional 2769877224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

4001 Worth St
Dallas, TX 75246-1608

9101 N Central Expy
Dallas, TX 75231-5947

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86117376TXMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Feb 14, 2022 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Healthtexas Provider Network CurrentSince Feb 14, 2022 Accepting new patients
Rayl Enterprises CurrentSince Oct 17, 2021 Accepting new patients

Locations

4251 FM 2181
Ste 230517
Corinth, TX 76210

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

9101 N Central Expy
Ste 420
Dallas, TX 75231
Phone (214) 820-8220

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

105 Kathryn Dr
Ste D
Lewisville, TX 75067
Phone (800) 972-0643

Organizations & group practices 4

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": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1568124865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 FM 2181 STE 230-517",
            "city": "CORINTH",
            "state": "TX",
            "postal_code": "762104219",
            "telephone_number": "800-972-0643",
            "fax_number": "214-279-5032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 KATHRYN DR STE D",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750674200",
            "telephone_number": "800-972-0643",
            "fax_number": "214-279-5032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGHRAM",
        "first_name": "VICTORIA",
        "middle_name": "ELIZABETH",
        "credential": "MCN, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "86117376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.