MARK A ACKERMANN (M.D.) – Obstetrics & Gynecology Physician, NPI 1104932466
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
630 OBSTETRICS/GYNECOLOGY in KY
Provider Addresses for MARK A ACKERMANN (M.D.)
330 LORETTO RD STE 500A
LEBANON, KY 400331308
Phone: (270) 699-2229
Fax: (270) 699-9740
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $139.
Total Amount is formed as General ($139) + Research ($0) + Ownership ($0) = $139.
Last reported payment date: 2024-08-19 • Largest payer in this snapshot: Aspira Women's Health Inc ($40).
Total Amount
$139
General + Research + Ownership
Payments
7
Total payment records
General Amount
$139
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-19
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-03-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120305000453 | I | Obstetrics/Gynecology | KY | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 40033)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | TN | |
| General Surgery | TN | |
| Orthopedic Surgery | TN | |
| P O D I A T R Y | KY | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| A N E S T H E S I O L O G Y | KY | |
| Orthopedic Surgery | KY | |
| Certified Nurse Midwife (Cnm) | KY |
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