Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Shaun Ingram

Individual provider Family Nurse Practitioner · NPI 1093377194

Dr. Shaun Ingram is a Nurse Practitioner in Memphis, Tennessee. Qualified in 2019, 7 years ago. Practices with Innovista Provider Group Texas PA, a 24-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
7
Licensed in
TN
In the registry since
2019
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Practice location Address checks out

4250 Faronia Rd Ste 4
Memphis, TN 38116-6527
Phone: (901) 348-9600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 25901 (TN)

Record details

NPI number1093377194
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 28, 2019
Last updated in NPPESAugust 9, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Innovista Provider Group Texas Pa — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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