MRS. MOLLY SMITH INGRAM (PA) – Physician Assistant, NPI 1396576732

MRS. MOLLY SMITH INGRAM (PA) is a healthcare provider. based in Augusta, Georgia. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 12634 (GA). The NPI Number for MRS. MOLLY SMITH INGRAM (PA) is 1396576732

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
MRS. MOLLY SMITH INGRAM (PA)
NPI
1396576732
Phone
(478) 365-1215
Address
516 MARTIN LN
Enumeration Date
8 August 2024
Last Update Date
10 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4702713415
Graduation Year
2024 (2 years ago)
PAC ID
9931636495
Group Practice PAC ID
8921176231
Professional Enrollment ID
I20241220003772
Address ID
GA302142110FA1267X2200500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness75
Years active:1State licenses:1Digital endpointsOther names

4,431 PHYSICIAN ASSISTANT in GA

Provider Addresses for MRS. MOLLY SMITH INGRAM (PA)

  • 516 MARTIN LN

    AUGUSTA, GA 309093406

    Phone: (478) 365-1215

    Type: Mailing

  • 1331 APPLING HARLEM RD

    HARLEM, GA 308144130

    Phone: (706) 556-2012

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-12-20

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
I20241220003772IPhysician AssistantGATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30909)

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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: 8921176231View full group profile
NameSpecialtyState
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerMN
Nurse PractitionerSC
Nurse PractitionerGA
Family Practice, General PracticeGA
Physician AssistantSC
-GA
General Practice, Family PracticeSC
Nurse PractitionerGA

Reviews

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Frequently asked questions

How do payers reference MRS. MOLLY SMITH INGRAM (PA)?
For MRS. MOLLY SMITH INGRAM (PA), use NPI 1396576732 as the unique 10-digit identifier.
Is there an active status for MRS. MOLLY SMITH INGRAM (PA)?
For scheduling context, MRS. MOLLY SMITH INGRAM (PA) is shown as active in the registry.
What clinical focus is listed for MRS. MOLLY SMITH INGRAM (PA)?
At a glance, MRS. MOLLY SMITH INGRAM (PA) is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
Where in Georgia is MRS. MOLLY SMITH INGRAM (PA) registered?
Use Augusta, Georgia as the headline location for MRS. MOLLY SMITH INGRAM (PA) here.
Does MRS. MOLLY SMITH INGRAM (PA) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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