MS. MARY R. INGRAM FNP
NPI 1164486452
Nurse Practitioner in Rapid City, SD

Q: What is Mary Ingram's NPI number?

The NPI number for Mary Ingram is 1164486452. It was assigned to this individual provider in the NPPES registry on April 13, 2006.

Q: What is Mary Ingram's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Ingram was last updated on November 8, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 13, 2006

3200 CANYON LAKE DR, RAPID CITY, SD 57702(605) 355-2443(605) 355-2403 Get Directions Write a Review

NPPES record last updated: November 8, 2011. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Ms. Mary R. Ingram Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. MARY R. INGRAM FNP (NPI 1164486452) is an individual nurse practitioner in Rapid City, South Dakota, licensed in South Dakota (RPO22257) and active in the NPI registry since April 2006.

NPPES Registry Identity

NPI1164486452

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMS. MARY R. INGRAMCredential: FNP

Location Address3200 CANYON LAKE DRRapid City, SD 57702-8114

Mailing Address3200 Canyon Lake DrRapid City, SD 57702-8114 · (605) 355-2443 · Fax (605) 355-2403

Phone(605) 355-2443

Fax(605) 355-2403

Sole ProprietorNo

Enumeration DateApril 13, 2006

Last NPPES UpdateNovember 8, 2011

✔ NPI 1164486452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in SD · RPO22257

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

3200 CANYON LAKE DR, Rapid City, SD 57702

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Other Identifiers 3

Medicaid5549050SD

Medicare UPINP34161SD

Medicare ID-Type Unspecified8HZ858SD

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ABBYGAIL BINGHAM MLT

Technician, Pathology