Victoria Fayth Ingram, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1203 W Augusta Blvd Ste 1
Chicago, IL 60642-4327

Phone

(773) 248-2255

NPI assigned

Jul 8, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bespoke PsychiatryGroup PAC ID 3274951744, 51 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Bespoke Psychiatry

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1952937104
  Care Compare group NPD
• Trevecca Nazarene University

  • Local Education Agency (LEA)
  • Nashville, TN
  • NPI 1033407952
  NPD (past)

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1639915713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BARBARA CT",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044949",
            "telephone_number": "314-608-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 W AUGUSTA BLVD STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606424327",
            "telephone_number": "773-248-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "VICTORIA",
        "middle_name": "FAYTH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latasha Ingram
• Marnita Ingram
• Rachel Erica Ingram
• Theodis Ingram Jr., REGISTERED DIETITIAN
• Tom Aaron Ingram
• Inherent Worth Counseling PLLC (Inherent Worth Counseling)
• Inhome Medical Services Inc
• Cindy Iniguez, M.A.
• Jose De Jesus Iniguez, PHD, LCPC
• Maira A Iniguez, LCPC

• Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.