Individual provider Active NPI

Angela Mullis-Ingram, NP

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1922045251
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3093102 Issued in FL
Practice address
408 E Michigan St
Orlando, FL 32806-4542
Phone
(866) 825-3227
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ARNP3093102 FL
Family Nurse Practitioner 363LF0000X 3093102 FL Primary

Addresses

Primary practice location

408 E Michigan St
Orlando, FL 32806-4542

Mailing address

161 Washington St FL 14
Eight Tower Bridge
Conshohocken, PA 19428-2083
Phone (866) 825-3227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20041023000012 FL Practitioner - Nurse Practitioner 3375504210 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3093102FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Central Florida LLP Emergency Medicine CurrentSince Sep 26, 2017 Accepting new patients
Guidewell Emergency Medicine Doctors, LLC PastSince Apr 6, 2025 Accepting new patients

Locations

1900 Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8761

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

1414 S Orange Ave
#112
Orlando, FL 32806
Phone (407) 767-1200

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1922045251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 WASHINGTON ST FL 14",
            "address_2": "EIGHT TOWER BRIDGE",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282083",
            "telephone_number": "866-825-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 E MICHIGAN ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328064542",
            "telephone_number": "866-825-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIS-INGRAM",
        "first_name": "ANGELA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ARNP3093102",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "3093102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.