Mary Inman, ACNPC-AG

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

207290 Issued in LA

Practice address

1449 E Bert Koun Loop Ste 100
Shreveport, LA 71105-5680

Phone

(318) 629-0220

Fax

(318) 629-0230

NPI assigned

Jul 18, 2019

Last updated

Jul 18, 2019By 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

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CH MSSP Services la LLCGroup PAC ID 6901206416, 44 clinicians

Curana Health of Louisiana LLCGroup PAC ID 4880731355, 140 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Curana Health of Louisiana LLC

  • Family Medicine Physician
  • Baton Rouge, LA
  • NPI 1538399704
  Medicare reassignment Care Compare group NPD
• CH MSSP Services la LLC

  • Internal Medicine Physician
  • Sulphur, LA
  • NPI 1982285060
  Medicare reassignment Care Compare group
• WK Shreveport Internal Medicine

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1255018388
  NPD

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1780237701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1449 E BERT KOUN LOOP STE 100",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055680",
            "telephone_number": "318-629-0220",
            "fax_number": "318-629-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1449 E BERT KOUN LOOP STE 100",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055680",
            "telephone_number": "318-629-0220",
            "fax_number": "318-629-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INMAN",
        "first_name": "MARY",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "LA",
            "license": "207290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Ing
• Kristofer Ingram
• Ingram's Nutrition Consultations
• Brent E Ingvardsen, CRNA
• Injurymd, LLC
• Inner Quality Transportation Services
• Inner Space LLC
• Innerlight Wellness, LLC
• Innovative Senior Solutions, LLC (Preferred Care at Home of Northwest Louisiana)
• Institutional Pharmacy Solutions

• Gerontology Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Gerontology Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; 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.