Individual provider Active NPI

Amanda Zachem, APRN

  • Family Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1073093357
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3012553 Issued in KY
Practice address
1780 Nicholasville Rd.
Suite #203
Lexington, KY 40503
Phone
(859) 277-7949
Fax
(859) 278-9279
NPI assigned
Aug 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3012553 KY Primary

Addresses

Primary practice location

1780 Nicholasville Rd.
Suite #203
Lexington, KY 40503

Mailing address

1780 Nicholasville Rd.
Suite #203
Lexington, KY 40503
Phone (859) 277-7949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3012553KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Kentucky PLLC CurrentSince Oct 15, 2018 Accepting new patients
Man O War Urgent Care LLC CurrentSince Apr 21, 2024 Accepting new patients
Brock Medical, LLC CurrentSince Oct 15, 2018 Accepting new patients
Onan Chiropractic PLLC CurrentSince Apr 21, 2024 Accepting new patients
Berea Urgent Care LLC CurrentSince Apr 21, 2024 Accepting new patients
Lexington Urgent Care PLLC CurrentSince Apr 21, 2024 Accepting new patients
Georgetown Urgent Care PLLC CurrentSince Apr 21, 2024 Accepting new patients
Mary Jane Lagrew, M.D., LLC Past Accepting new patients

Locations

234 Brenwood St
Berea, KY 40403
Phone (859) 985-0302

301 Versailles Rd
Frankfort, KY 40601
Phone (502) 352-2310

111 Osborne Way
#101
Georgetown, KY 40324
Phone (859) 466-8956

4097 Nichols Park Dr
Ste 108
Lexington, KY 40503
Phone (859) 245-2273

1701 Nicholasville Rd
Ste 100
Lexington, KY 40503
Phone (859) 466-8956

1649 Highway 192 W
London, KY 40741
Phone (606) 330-0055

197 E Brannon Rd
Nicholasville, KY 40356
Phone (859) 523-5310

432 Lexington Rd
Versailles, KY 40383
Phone (859) 523-5310

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1073093357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1780 NICHOLASVILLE RD.",
            "address_2": "SUITE #203",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40503",
            "telephone_number": "859-277-7949",
            "fax_number": "859-278-9279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 NICHOLASVILLE RD.",
            "address_2": "SUITE #203",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40503",
            "telephone_number": "859-277-7949",
            "fax_number": "859-278-9279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHEM",
        "first_name": "AMANDA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3012553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.