NPIMap

Individual provider Active NPI

Achamma S Itticheria, MD

  • Family Medicine Physician
  • Lexington, KY
National Provider Identifier
1942415732
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
44836 Issued in KY
Practice address
828 Lane Allen Rd Ste 219
Lexington, KY 40504
Phone
(502) 498-4071
Fax
(888) 423-5216
NPI assigned
May 14, 2007
Last updated
Feb 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 44836 KY Primary

Addresses

Primary practice location

828 Lane Allen Rd Ste 219
Lexington, KY 40504

Mailing address

PO Box 3299
Carson City, NV 89702-3299
Phone (775) 222-0044

Other identifiers 1

IdentifierTypeStateIssuer
7100263350MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120726000114 KY Practitioner - Family PracticePractitioner - General PracticePractitioner - General SurgeryPractitioner - Geriatric Medicine 9133385719 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eventus Ecs, IncGroup PAC ID 2163969650, 243 clinicians
Extended Care Specialists, IncGroup PAC ID 2466407713, 295 clinicians
Eventus Wholehealth Midwest IncGroup PAC ID 4183040470, 120 clinicians

Practice addresses (Care Compare)

306 W Main St
Suite 512
Frankfort, KY 40601-1840
Phone (855) 743-2247

828 Lane Allen Rd
Suite 219
Lexington, KY 40504-3659
Phone (260) 483-9081

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Provider Partners Care Management LP Family Medicine CurrentSince Apr 7, 2025 Accepting new patients
Eventus Ecs, Inc Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Extended Care Specialists, Inc Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Eventus Wholehealth Midwest Inc Family Medicine CurrentSince Oct 31, 2025 Accepting new patients
Eventus Ecs - Kentucky, PLLC CurrentSince Sep 1, 2025 Accepting new patients
Eventus WH Midwest Care, LLC Family Medicine CurrentSince Jan 3, 2026 Accepting new patients
Monticello Ky Opco LLC Past Accepting new patients
HBR Elizabethtown, LLC Past Accepting new patients
LP Louisville Quinn Drive, LLC Past Accepting new patients
Williamstown Ky Opco LLC Past Accepting new patients
Carmel Manor Inc. Past Accepting new patients
LP Bardstown, LLC Past Accepting new patients
Owenton Ky Opco LLC Past Accepting new patients
Pearl Medical Practice PLLC PastSince Jan 31, 2021 Accepting new patients
Kensington Health Center LLC Past Accepting new patients

Locations

922 State St
Fl 4
Bowling Green, KY 42101

306 W Main St
Ste 512
Frankfort, KY 40601
Phone (860) 215-2295

828 Lane Allen Rd
Ste 219
Lexington, KY 40504
Phone (317) 782-1577

446 Mount Holly Ave
Louisville, KY 40206
Phone (502) 897-1646

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (317) 432-0682

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Carmel Manor IncFort Thomas, KY, CCN 185208 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 4, 2025
Nov 4, 2025
Kensington Nursing and Rehabilitation CenterElizabethtown, KY, CCN 185443 Skilled nursing facility Adp of the SNF Jan 1, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 12

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1942415732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3299",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897023299",
            "telephone_number": "775-222-0044",
            "fax_number": "888-700-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 LANE ALLEN RD STE 219",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40504",
            "telephone_number": "502-498-4071",
            "fax_number": "888-423-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITTICHERIA",
        "first_name": "ACHAMMA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "44836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100263350",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.