Kristen Ingram

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

R887211 Issued in MS

Practice address

200 Hospital Dr W
Hattiesburg, MS 39402-1346

Phone

(601) 296-3000

Fax

(601) 296-3001

NPI assigned

Jun 11, 2015

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8276/brand/1/csg/1/fhir/r4
• Direct secure messaging: kristen.ingram@sdma.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pioneer Health Care , LLC

  • General Practice Physician
  • Bassfield, MS
  • NPI 1336384742
  Medicare reassignment NPD
• Southern Surgical Associates, P. a.

  • Specialist
  • Hattiesburg, MS
  • NPI 1265551162
  Medicare reassignment NPD
• Conx Care Corporation

  • Family Medicine Physician
  • Hattiesburg, MS
  • NPI 1548183510
  NPD (past)

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1689055089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DR W",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021346",
            "telephone_number": "601-296-3000",
            "fax_number": "601-296-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DR W",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021346",
            "telephone_number": "601-296-3000",
            "fax_number": "601-296-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MS",
            "license": "R887211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05789651",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Impeccable Prehire Agency, LLC
• Antonio Jaime Torres Imperial Jr., M.D.
• Neha Sunil Ingle
• Carmen Ingram, CRNA
• Kimberly Kerr Ingram, D.M.D.
• Whitney Ingram, IDD WAIVER SERVICES
• Inhome Care Inc (Home Instead Senior Care)
• Inhome Care, Inc
• Inland Family Practice Center LLC
• Carley Lakenn Inmon

• Gerontology Nurse Practitioner in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Gerontology Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.