Individual provider Active NPI

Patricia P Ingold, PA-C

  • Medical Physician Assistant
  • Columbus, GA
National Provider Identifier
1700893963
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
004546 Issued in GA
Practice address
610 19TH St
Columbus, GA 31901-1528
Phone
(706) 322-7884
Fax
(706) 243-4356
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 004546 GA Primary

Addresses

Primary practice location

610 19TH St
Columbus, GA 31901-1528

Mailing address

2300 Manchester Expy Ste 2001a
Columbus, GA 31904-6802
Phone (706) 320-3126

Other identifiers 2

IdentifierTypeStateIssuer
003144470BMedicaidGA
170238MedicaidAL

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20050907000617 GA Practitioner - Physician Assistant 7719919042 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Physician Group of Georgia LLCGroup PAC ID 9638699648, 31 clinicians

Practice addresses (Care Compare)

610 19TH St
Columbus, GA 31901-1528
Phone (706) 322-7884

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
004546GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Affiliated Services LLC CurrentSince Feb 13, 2023 Accepting new patients
Mac - Macon Road LLC Current Accepting new patients
Pulmonary Medicine Inc Past Accepting new patients
Millennium Independent Provider Network of Georgia, LLC Past Accepting new patients
Endoscopy Center of Columbus, LLC Past Accepting new patients

Locations

610 19th St
Columbus, GA 31901
Phone (706) 322-7884

3465 Macon Rd
Ste D
Columbus, GA 31907
Phone (706) 243-3051

Interoperability endpoints

  • Direct secure messaging: patricia.ingold.1@32140.direct.athenahealth.com

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1700893963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MANCHESTER EXPY STE 2001A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046802",
            "telephone_number": "706-320-3126",
            "fax_number": "706-320-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 19TH ST",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319011528",
            "telephone_number": "706-322-7884",
            "fax_number": "706-243-4356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGOLD",
        "first_name": "PATRICIA",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "004546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003144470B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170238",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.