Individual provider Active NPI

Cassie Coulter Ingrum, NP-C

  • Family Nurse Practitioner
  • Athens, AL
National Provider Identifier
1972887123
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-117675 Issued in AL
Practice address
101 Fitness Way Ste 2700
Athens, AL 35611-2495
Phone
(256) 233-9273
Fax
(256) 216-1920
NPI assigned
Oct 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-117675 AL Primary

Addresses

Primary practice location

101 Fitness Way Ste 2700
Athens, AL 35611-2495

Mailing address

101 Fitness Way Ste 2700
Athens, AL 35611-2495
Phone (256) 233-9273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20241125003202 AL Practitioner - Nurse Practitioner 3274780523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HH Heart Center, LLCGroup PAC ID 1951694678, 94 clinicians

Practice addresses (Care Compare)

101 Fitness Way
Suite 2700
Athens, AL 35611-2495
Phone (256) 233-9273

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
HH Heart Center, LLC Family CurrentSince Aug 1, 2024 Accepting new patients
Southeastern Medical Group, LLC PastSince Mar 14, 2020 Accepting new patients

Locations

101 Fitness Way
Ste 2700
Athens, AL 35611
Phone (256) 233-9273

930 Franklin St SE
Huntsville, AL 35801

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1972887123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 FITNESS WAY STE 2700",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356112495",
            "telephone_number": "256-233-9273",
            "fax_number": "256-216-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 FITNESS WAY STE 2700",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356112495",
            "telephone_number": "256-233-9273",
            "fax_number": "256-216-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRUM",
        "first_name": "CASSIE",
        "middle_name": "COULTER",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-06",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-117675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, AL

Sources for this page

Verify at the official NPI Registry.