AUDRA MARCUM ARNP
NPI 1497703987
Nurse Practitioner - Acute Care in Lexington, KY

Q: What is Audra Marcum's NPI number?

The NPI number for Audra Marcum is 1497703987. It was assigned to this individual provider in the NPPES registry on May 5, 2006. The provider is also known as Audra Summers Arnp.

Q: What is Audra Marcum's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Audra Marcum was last updated on December 9, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 05, 2006PECOS EnrolledAccepts Medicare Assignment

95.5/100

CMS Quality Rating

166 PASADENA DR, SUITE 100, LEXINGTON, KY 40503(859) 278-0319(859) 277-9699 Get Directions Write a Review

NPPES record last updated: December 9, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 9, 2020, Aug 1, 2018 (2 updates tracked since 2018).

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About Audra Marcum Arnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AUDRA MARCUM ARNP (NPI 1497703987) is an individual acute care provider in Lexington, Kentucky, licensed in Kentucky (3004628) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Baptist Health Richmond, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1497703987

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameAUDRA MARCUMCredential: ARNP

Location Address166 PASADENA DR, SUITE 100Lexington, KY 40503-2973

Mailing Address230 Lexington Green Cir, Ste 600Lexington, KY 40503-3326 · (859) 971-4695 · Fax (859) 971-4604

Phone(859) 278-0319

Fax(859) 277-9699

Sole ProprietorNo

Medical School CMSOtherGraduated 2005

Enumeration DateMay 5, 2006

Last NPPES UpdateDecember 9, 20202 updates tracked since enumeration

NPPES CertifiedDecember 9, 2020

✔ NPI 1497703987 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in KY · 3004628

166 PASADENA DR, Lexington, KY 40503

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Other Names 1

Former Name (1)Audra Summers Arnp

Other Identifiers 1

Medicaid78016938KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Audra Marcum Arnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638180979

PECOS Enrollment IDI20060525000179

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 14

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

504 services329 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

174 services170 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

172 services169 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

126 services116 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

95 services95 patients

Test to measure rate of airflow 94375

This test, known as spirometry, measures how much air you can breathe in and out, and how quickly you can do so. It helps assess your lung function and can be used to diagnose or monitor conditions like asthma or COPD.

80 services80 patients

Test for exercise-induced lung stress 94618

An exercise-induced lung stress test assesses how your lungs respond to physical activity. During the test, you'll exercise on a treadmill or stationary bike while your heart rate, breathing, blood pressure, and oxygen levels are monitored. This helps identify any abnormal lung responses to exercise.

22 services20 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

21 services21 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

20 services20 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

20 services20 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

19 services19 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

18 services16 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

14 services14 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

13 services13 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baptist Health Richmond

Acute Care Hospitals · Richmond, KY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180049

Location801 Eastern BypassRichmond, KY 40475 · Madison County

Emergency services Birthing friendly

Baptist Health Lexington

Acute Care Hospitals · Lexington, KY

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number180103

Location1740 Nicholasville RoadLexington, KY 40503 · Fayette County

Emergency services Birthing friendly

Saint Joseph East

Acute Care Hospitals · Lexington, KY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180143

Location150 North Eagle Creek DriveLexington, KY 40509 · Fayette County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40503 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.5/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

89.59

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 32

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

13 suppliers42 claims42 services$40.31 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

8 suppliers60 claims122 services$1.82 avg. paid by Medicare

Small volume nonfiltered pneumatic nebulizer, disposable A7004

DME-Other DME · category DE000N

3 suppliers15 claims34 services$1.31 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable A7005

DME-Other DME · category DE000N

13 suppliers35 claims35 services$14.54 avg. paid by Medicare

Aerosol mask, used with dme nebulizer A7015

DME-Other DME · category DE000N

3 suppliers16 claims16 services$1.43 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

13 suppliers32 claims32 services$101.18 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

12 suppliers31 claims90 services$39.24 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

9 suppliers34 claims170 services$23.74 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

5 suppliers18 claims97 services$15.21 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

12 suppliers53 claims53 services$65.72 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

15 suppliers43 claims43 services$20.85 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

10 suppliers35 claims35 services$19.32 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

18 suppliers84 claims447 services$2.76 avg. paid by Medicare

Filter, non disposable, used with positive airway pressure device A7039

DME-Other DME · category DE001N

10 suppliers18 claims18 services$7.47 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

12 suppliers29 claims29 services$13.53 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

10 suppliers140 claims142 services$15.67 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

8 suppliers82 claims82 services$912.76 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470

DME-Other DME · category DE001N

3 suppliers31 claims31 services$96.06 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

4 suppliers22 claims22 services$15.40 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

14 suppliers121 claims123 services$7.09 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

4 suppliers34 claims34 services$50.36 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

25 suppliers565 claims567 services$96.24 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

15 suppliers209 claims209 services$34.73 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary G0333

DME-Other DME · category DE000N

8 suppliers14 claims14 services$45.08 avg. paid by Medicare

Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605

DME-Drugs Administered Through DME · category DG006N

5 suppliers44 claims3,120 services$4.34 avg. paid by Medicare

Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms J7606

DME-Drugs Administered Through DME · category DG006N

5 suppliers68 claims4,080 services$6.52 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

19 suppliers87 claims18,481 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

16 suppliers111 claims11,250 services$0.09 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

8 suppliers117 claims7,320 services$0.81 avg. paid by Medicare

Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram J7644

DME-Drugs Administered Through DME · category DG006N

4 suppliers14 claims776 services$0.15 avg. paid by Medicare

Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram J7677

DME-Drugs Administered Through DME · category DG006N

5 suppliers66 claims346,500 services$0.15 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

33 suppliers308 claims308 services$24.80 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSEPH CONRAD MUELLER MD

Internal Medicine (Pulmonary Disease)

166 PASADENA DR, SUITE 100
LEXINGTON, KY 40503

Fayette County (859) 278-0319

JULIE ABNEY APRN

Nurse Practitioner (Family)

166 PASADENA DR, SUITE 100
LEXINGTON, KY 40503

Fayette County (859) 278-0319

MARLANA LYNN KEETON APRN

Nurse Practitioner (Family)

166 PASADENA DR, SUITE 100
LEXINGTON, KY 40503

Fayette County (859) 278-0319

MELANIE HARDIN-PIERCE APRN

Nurse Practitioner (Family)

166 PASADENA DR, SUITE 100
LEXINGTON, KY 40503

Fayette County (859) 278-0319

DONNA CLAY GERHARDSTEIN MD

Internal Medicine (Pulmonary Disease)

166 PASADENA DR
LEXINGTON, KY 40503

Fayette County (859) 278-0319

BAPTIST PHYSICIANS LEXINGTON, INC

Internal Medicine (Pulmonary Disease)

166 PASADENA DR, SUITE 100
LEXINGTON, KY 40503

Fayette County (859) 278-0319

JOHN SYLVESTER HILL MD

Allergy & Immunology

166 PASADENA DR, STE 150
LEXINGTON, KY 40503

Fayette County (859) 276-1452

ALLERGY & ASTHMA PHYSICIANS OF CENTRAL KENTUCKY, PSC

Allergy & Immunology

166 PASADENA DR, SUITE 150
LEXINGTON, KY 40503

Fayette County (859) 276-1452

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Audra Marcum's NPI number?

The NPI number for Audra Marcum is 1497703987. It was assigned to this individual provider in the NPPES registry on May 5, 2006. The provider is also known as Audra Summers Arnp.

Where is Audra Marcum located?

Audra Marcum practices at 166 Pasadena Dr Suite 100, Lexington, KY 40503. The listed phone number is (859) 278-0319.

What is Audra Marcum's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Audra Marcum enrolled in Medicare?

Yes. Audra Marcum is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Audra Marcum accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Audra Marcum as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Audra Marcum affiliated with any hospitals?

According to CMS data, Audra Marcum is affiliated with Baptist Health Richmond, Baptist Health Lexington and Saint Joseph East.

When was this NPI record last updated?

The NPPES record for Audra Marcum was last updated on December 9, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.