Individual provider Active NPI

Mark A Ackermann, M.D.

  • Obstetrics & Gynecology Physician
  • Lebanon, KY
National Provider Identifier
1104932466
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
32261 Issued in 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
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 32261 KY Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120305000453 KY Practitioner - Obstetrics/Gynecology 6800988106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Louisville School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32261KYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spring View Physician Practices, LLC CurrentSince May 18, 2015 Accepting new patients
Spring View Physician Practices, LLC Obstetrics & Gynecology Current Accepting new patients
Spring View Physician Practices LLC CurrentSince May 18, 2015 Accepting new patients
Lebanon Physicians for Women Obstetrics & Gynecology Past Accepting new patients
Spring View Physician Practices, LLC Past Accepting new patients
Spring View Hospital LLC Past Accepting new patients

Locations

330 N Loretto Rd
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
Ste 500A
Lebanon, KY 40033
Phone (270) 699-2229

420 N Loretto Rd
Ste 200
Lebanon, KY 40033
Phone 2703214480 ext. 306

420 N Loretto Rd
Ste 600
Lebanon, KY 40033
Phone (270) 692-5139

Interoperability endpoints

  • Direct secure messaging: mark.ackermann.1@30070.direct.athenahealth.com

Organizations & group practices 6

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104932466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 LORETTO RD STE 500A",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331308",
            "telephone_number": "270-699-2229",
            "fax_number": "270-699-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 LORETTO RD STE 500A",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331308",
            "telephone_number": "270-699-2229",
            "fax_number": "270-699-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMANN",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "32261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, KY

Sources for this page

Verify at the official NPI Registry.