NPIMap

Individual provider Active NPI

Lillian Ingram

  • Psychiatric/Mental Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1942564711
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP9359459 Issued in FL
Practice address
1211 Tech Blvd Ste 105
Tampa, FL 33619-7846
Phone
(813) 999-1516
Fax
(813) 336-8384
NPI assigned
Jun 27, 2012
Last updated
Feb 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9359459 FL
Family Nurse Practitioner 363LF0000X RN223698 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN02951 RI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP9359459 FL Primary

Addresses

Primary practice location

1211 Tech Blvd Ste 105
Tampa, FL 33619-7846

Mailing address

1211 Tech Blvd Ste 105
Tampa, FL 33619-7846
Phone (813) 999-1516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130611000518 FL Practitioner - Nurse Practitioner 1759520349 Reassigns benefits to 4 organizations
Practice locations: Tampa, FL

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Learning to Achieve Wellness IncGroup PAC ID 9234514464, 48 clinicians

Practice addresses (Care Compare)

1211 Tech Blvd
Suite 111
Tampa, FL 33619-7846
Phone (813) 999-1516

413 W Robertson St
Brandon, FL 33511-5014
Phone (813) 999-1516

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN223698GAMDFamily Nurse Practitioner
APRN02951RIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Learning to Achieve Wellness Inc Psychiatric/Mental Health CurrentSince May 27, 2022 Accepting new patients
Inpatient Consultants of Florida, Inc CurrentSince Oct 1, 2017 Accepting new patients
Inpatient Consultants of Florida Inc CurrentSince Oct 1, 2017 Accepting new patients
Lillian Ingram Family CurrentSince Nov 18, 2021 Accepting new patients

Locations

413 W Robertson St
Ste B
Brandon, FL 33511
Phone (813) 657-4711

4325 Southpoint Blvd
Jacksonville, FL 32216
Phone (904) 245-7620

2029 Professional Center Dr
Orange Park, FL 32073
Phone (904) 264-8621

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

1211 Tech Blvd
Ste 105
Tampa, FL 33619

1211 Tech Blvd
Ste 111
Tampa, FL 33619

1211 Tech Blvd
Ste 125B
Tampa, FL 33619

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-0793

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1942564711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 TECH BLVD STE 105",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336197846",
            "telephone_number": "813-999-1516",
            "fax_number": "813-336-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 TECH BLVD STE 105",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336197846",
            "telephone_number": "813-999-1516",
            "fax_number": "813-336-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "LILLIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9359459",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN223698",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "APRN02951",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9359459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.