Individual provider Active NPI

Tawnya J Ingimundson, CNP

  • Obstetrics Physician
  • Albuquerque, NM
National Provider Identifier
1821183005
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
R41588 Issued in NM
Practice address
6621 Gulton CT NE
Albuquerque, NM 87109-4407
Phone
(505) 888-0443
Fax
(505) 888-1398
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X R41588 NM Primary

Addresses

Primary practice location

6621 Gulton CT NE
Albuquerque, NM 87109-4407

Mailing address

6621 Gulton CT NE
Albuquerque, NM 87109-4407
Phone (505) 888-0443

Other identifiers 1

IdentifierTypeStateIssuer
000B9556MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20050422001104 NM Practitioner - Nurse Practitioner 9234177890 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Womens Pelvic Specialty Care of New Mexico LLCGroup PAC ID 8729305909, 3 clinicians

Practice addresses (Care Compare)

6621 Gulton CT NE
Albuquerque, NM 87109-4407
Phone (505) 888-0443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R41588NMMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Feb 1, 2000 Accepting new patients
Presbyterian Healthcare Services CurrentSince Feb 1, 2000 Accepting new patients
Women'S Pelvic Specialty Care of New Mexico, LLC CurrentSince Jan 22, 2022 Accepting new patients

Locations

201 Cedar St SE
Ste 5600
Albuquerque, NM 87106
Phone (505) 554-7836

6621 Gulton Ct NE
Albuquerque, NM 87109
Phone (505) 888-0443

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

Organizations & group practices 3

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1821183005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 GULTON CT NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094407",
            "telephone_number": "505-888-0443",
            "fax_number": "505-888-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 GULTON CT NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094407",
            "telephone_number": "505-888-0443",
            "fax_number": "505-888-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGIMUNDSON",
        "first_name": "TAWNYA",
        "middle_name": "J",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NM",
            "license": "R41588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000B9556",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.