LISA GAYE INGRAM (MSN, APRN, FNP) – Nurse Practitioner, NPI 1104456235

LISA GAYE INGRAM (MSN, APRN, FNP) is a healthcare provider. based in Thomaston, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials MSN, APRN, FNP. They hold a License No. RN062064 (GA). The NPI Number for LISA GAYE INGRAM (MSN, APRN, FNP) is 1104456235

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
LISA GAYE INGRAM (MSN, APRN, FNP)
NPI
1104456235
Phone
(706) 647-8111
Address
PO BOX 1059
Enumeration Date
16 January 2020
Last Update Date
16 January 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7068461202
Graduation Year
2019 (7 years ago)
PAC ID
8820426455
Group Practice PAC ID
4789913328
Professional Enrollment ID
I20200314000001
Address ID
GA302866209TH502XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

9,652 NURSE PRACTITIONER in GA

Provider Addresses for LISA GAYE INGRAM (MSN, APRN, FNP)

  • PO BOX 1059

    THOMASTON, GA 302860027

    Phone: (706) 647-8111

    Fax: (706) 646-3153

    Type: Mailing

  • 801 W GORDON ST

    THOMASTON, GA 302863426

    Phone: (706) 647-8111

    Fax: (706) 646-3153

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 126 Open Payments records for all available years, with a total value of $1,958.

Total Amount is formed as General ($1,958) + Research ($0) + Ownership ($0) = $1,958.

Last reported payment date: 2024-09-12 • Largest payer in this snapshot: Novo Nordisk Inc ($368).

Total Amount

$1,958

General + Research + Ownership

Payments

126

Total payment records

General Amount

$1,958

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-12

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-03-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200314000001INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J1100Injection, dexamethasone sodium phosphate, 1 mg6414$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit3535$0
36415Insertion of needle into vein for collection of blood sample2521$0
96372Injection of drug or substance under skin or into muscle2514$0
99214Established patient office or other outpatient visit, 30-39 minutes2420$0
View full utilization report →

Insurance plans in this area (ZIP 30286)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789913328View full group profile
NameSpecialtyState
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA

Reviews

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Frequently asked questions

What identifier follows LISA GAYE INGRAM (MSN, APRN, FNP) across health systems?
The NPI 1104456235 uniquely identifies LISA GAYE INGRAM (MSN, APRN, FNP) in U.S. healthcare data.
Quick check: is LISA GAYE INGRAM (MSN, APRN, FNP) active?
Public NPPES data shows LISA GAYE INGRAM (MSN, APRN, FNP) with an active NPI status right now.
How should patients interpret LISA GAYE INGRAM (MSN, APRN, FNP)'s specialty?
The extract shows Nurse Practitioner for LISA GAYE INGRAM (MSN, APRN, FNP). Clinical services aligned with this taxonomy classification.
Can patients visit LISA GAYE INGRAM (MSN, APRN, FNP) in Thomaston, Georgia?
For routing, start with Thomaston, Georgia for LISA GAYE INGRAM (MSN, APRN, FNP), then verify phone and hours locally.
Can I export LISA GAYE INGRAM (MSN, APRN, FNP)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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