Individual provider Active NPI

Nancy M Ingram

  • Audiologist
  • Tulsa, OK
National Provider Identifier
1902877905
Registry record updated Nov 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
108 Issued in OK
Practice address
4415 S Harvard Ave
Suite 125
Tulsa, OK 74135-2620
Phone
(918) 508-7601
Fax
(918) 508-7602
NPI assigned
Jan 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 108 OK Primary

Addresses

Primary practice location

4415 S Harvard Ave
Suite 125
Tulsa, OK 74135-2620

Mailing address

4415 S Harvard Ave
Suite 125
Tulsa, OK 74135-2620
Phone (918) 508-7601

Other identifiers 1

IdentifierTypeStateIssuer
200046630AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
108OKMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom Hearing Audiologist PastSince May 1, 2020 Accepting new patients

Organizations & group practices 1

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": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1902877905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 S HARVARD AVE",
            "address_2": "SUITE 125",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352620",
            "telephone_number": "918-508-7601",
            "fax_number": "918-508-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 S HARVARD AVE",
            "address_2": "SUITE 125",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352620",
            "telephone_number": "918-508-7601",
            "fax_number": "918-508-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "NANCY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-28",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OK",
            "license": "108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200046630A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.