Mark A Ackermann, M.D.
Individual provider Active NPI Obstetrics & Gynecology Physician · Lebanon, KY
NPI 1104932466 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104932466
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 32261 (KY)
- Practice address
- 330 Loretto Rd Ste 500a
Lebanon, KY 40033-1308 - Phone
- (270) 699-2229
- Fax
- (270) 699-9740
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- University of Louisville School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Spring View Physician Practices LLC
Practice addresses (Care Compare)
320 N Loretto Rd
Lebanon, KY 40033-1300
Phone (270) 692-5152
330 N Loretto Rd
Lebanon, KY 40033-1300
Phone (270) 699-4638
330 N Loretto Rd
Suite 500a
Lebanon, KY 40033-1308
Phone (270) 699-2229
420 N Loretto Rd
Suite 600
Lebanon, KY 40033-1634
Phone (270) 692-5139
Hospital & facility affiliations
- Spring View Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120305000453 | KY | Practitioner - Obstetrics/Gynecology | 6800988106 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32261 | KY | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spring View Physician Practices LLC | Current |
Accepting new patients | |
| Spring View Physician Practices, LLC | Current |
Accepting new patients | |
| Spring View Physician Practices, LLC | Obstetrics & Gynecology | Current | Accepting new patients |
| Lebanon Physicians for Women | Obstetrics & Gynecology | Past | Accepting new patients |
| Spring View Hospital LLC | Past | Accepting new patients | |
| Spring View Physician Practices, LLC | Past | Accepting new patients |
Locations
320 N Loretto Rd
Lebanon, KY 40033
Phone (270) 692-3161
420 N Loretto Rd
Ste 200
Lebanon, KY 40033
Phone 2703214480 ext. 306
330 N Loretto Rd
Ste 500A
Lebanon, KY 40033
Phone (270) 699-2229
330 N Loretto Rd
#500
Lebanon, KY 40033
Phone (270) 699-2229
330 N Loretto Rd
Ste 500
Lebanon, KY 40033
330 N Loretto Rd
Lebanon, KY 40033
Phone (270) 699-2229
420 N Loretto Rd
Ste 600
Lebanon, KY 40033
Phone (270) 692-5139
Interoperability endpoints
- mark.ackermann.1@30070.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 32261 | KY | Yes |
Addresses
Primary practice location
330 Loretto Rd Ste 500a
Lebanon, KY 40033-1308
Mailing address
330 Loretto Rd Ste 500a
Lebanon, KY 40033-1308
Phone (270) 699-2229
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64319973 | Medicaid | KY |
Other providers in Lebanon, KY
- A1 Health Care Clinic
- Atam Abbi
- Tammy L Abel
- Laura Bandy Abell
- John Barry Adams Sr.
- Air Evac EMS, Inc.
- Alternative Health Solutions
- Angelica Anderson
- Emmanuel Awah
All providers in Lebanon, KY · Obstetrics & Gynecology Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.