PHYLLIS ANNETTE INGHAM (NP-C) – Nurse Practitioner, NPI 1003328667
Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
2,370 NURSE PRACTITIONER in NM
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Provider Addresses for PHYLLIS ANNETTE INGHAM (NP-C)
1100, Lead Avenue Southeast, Silver Hill, Martinez Town, Albuquerque, Bernalillo County, New Mexico, 87106, United States
ALBUQUERQUE, NM 871065215
Phone: (505) 224-7000
Type: Location
PO BOX 26666
PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 871256666
Phone: (505) 923-6770
Fax: (505) 923-5354
Type: Mailing
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 468451701
Phone:
Type: Mailing
750 N BROADWAY
PERU, IN 469701027
Phone: (260) 569-2120
Fax: (260) 569-2121
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $27.
Total Amount is formed as General ($27) + Research ($0) + Ownership ($0) = $27.
Last reported payment date: 2024-06-14 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($17).
Total Amount
$27
General + Research + Ownership
Payments
2
Total payment records
General Amount
$27
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $17 |
| Corium, LLC | $11 |
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: 2019-10-08
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20191008003920 | I | Nurse Practitioner | IN | TBD |
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.
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 87106)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pediatric Medicine | IN | |
| Family Practice, Emergency Medicine | IN | |
| Family Practice | IN | |
| Nurse Practitioner | IN | |
| Family Practice | IN | |
| Nurse Practitioner | IN | |
| Family Practice | IN | |
| Orthopedic Surgery | IN | |
| Nurse Practitioner | IN | |
| Physician Assistant | IN |
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