VIRGINIA ANN MARCUM APRN
NPI 1619463270
Nurse Practitioner - Family in London, KY

Q: What is Virginia Marcum's NPI number?

The NPI number for Virginia Marcum is 1619463270. It was assigned to this individual provider in the NPPES registry on July 6, 2018.

Q: What is Virginia Marcum's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Virginia Marcum was last updated on June 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 06, 2018PECOS EnrolledAccepts Medicare Assignment

87.53/100

CMS Quality Rating

100 LONDON MOUNTAIN VIEW DR FL 1, LONDON, KY 40741(859) 275-5229(859) 977-2683 Get Directions Write a Review

NPPES record last updated: June 9, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 9, 2022, Jan 12, 2021, Oct 19, 2018 and 2 more (5 updates tracked since 2018).

On this page

About Virginia Ann Marcum Aprn NPPES

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

VIRGINIA ANN MARCUM APRN (NPI 1619463270) is an individual family provider in London, Kentucky, licensed in Kentucky (3012462) and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS, is affiliated with Saint Joseph London, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1619463270

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameVIRGINIA ANN MARCUMCredential: APRN

Location Address100 LONDON MOUNTAIN VIEW DR FL 1London, KY 40741-6668

Mailing AddressPo Box 21890Belfast, ME 04915-4115 · (502) 907-0356 · Fax (502) 919-9780

Phone(859) 275-5229

Fax(859) 977-2683

Sole ProprietorYes

Medical School CMSOtherGraduated 2018

Enumeration DateJuly 6, 2018

Last NPPES UpdateJune 9, 20225 updates tracked since enumeration

NPPES CertifiedJune 9, 2022

✔ NPI 1619463270 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in KY · 3012462

100 LONDON MOUNTAIN VIEW DR FL 1, London, KY 40741

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Other Identifiers 10

Other2017955KY · Wellcare Of Ky Provider Id Number

Other6436712Cigna Provider Id Number

Other6636596Aetna Provider Id Number

OtherCS1930500243Caresource Provider Id Number

Other6929516United Healthcare Provider Id Number

OtherPDZ000000326570KY · Aetna Better Health Of Ky Provider Id Number

Other000001302666Anthem Provider Id Number

Medicaid300030020IN

Other14286219Caqh

Medicaid7100579870KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, 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

Virginia Ann Marcum Aprn 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 ID1850644188

PECOS Enrollment IDI20181102000484

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 5

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.

Testing for presence of drug, by chemistry analyzers 80307

Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.

346 services168 patients

Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms G0481

A definitive drug test is a detailed analysis used to identify specific drugs in your system. It uses advanced techniques, such as gc/ms and lc/ms, to detect and distinguish between different drugs, even those with similar structures.

323 services152 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.

249 services132 patients

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.

175 services118 patients

A definitive drug test is a detailed examination that can identify specific drugs in your system, even closely related ones. Techniques like GC/MS and LC/MS are used for high precision. This helps ensure accurate results for your safety and health.

26 services22 patients

Hospital Affiliations CMS Care Compare 2

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

Saint Joseph London

Acute Care Hospitals · London, KY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180011

Location1001 Saint Joseph LaneLondon, KY 40741 · Laurel County

Emergency services Birthing friendly

Baptist Health Corbin

Acute Care Hospitals · Corbin, KY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180080

LocationOne Trillium WayCorbin, KY 40701 · Whitley County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40741 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.

87.53/100

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

Scored as part of a group practice

Quality

80.58

Promoting Interoperability

100

Improvement Activities

Cost

68.08

Reported Quality Measures

Advance Care Plan

99%298 patients4/55-star benchmark: 100%

Closing the Referral Loop: Receipt of Specialist Report

2%54 patients1/55-star benchmark: 87%

Controlling High Blood Pressure

45%49 patients2/55-star benchmark: 91%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

98%64 patients1/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

100%4,400 patients5/55-star benchmark: 100%

e-Prescribing

100%679 patients5/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

78%1,107 patients4/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

61%1,031 patients3/55-star benchmark: 97%

Provide Patients Electronic Access to Their Health Information

74%724 patients3/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 2% · 306 patients

Patients totalRate: 8% · 306 patients

7%306 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 8

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

MRS. STEPHANIE MARIE SUMNER APRN, FNP-C

Nurse Practitioner (Family)