Organization
ORTHOCINCY ORTHOPAEDICS & SPORTS MEDICINE PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANN M REIS CEO (CEO/MANAGER)
(859) 817-7070
Entity
Organization
Contact information
Practice address
8726 US 42, FLORENCE, KY 41042
(859) 301-2663
(859) 301-0655
Mailing address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 301-2663
(859) 301-0655
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
—
KY
207R00000X
Internal Medicine Physician
—
KY
207RM1200X
Magnetic Resonance Imaging (MRI) Internal Medicine Physician
—
KY
207X00000X
Orthopaedic Surgery Physician
Primary
—
KY
207XS0106X
Orthopaedic Hand Surgery Physician
—
KY
213E00000X
Podiatrist
—
KY
225100000X
Physical Therapist
—
KY
332B00000X
Durable Medical Equipment & Medical Supplies
—
KY
363AM0700X
Medical Physician Assistant
—
KY
363L00000X
Nurse Practitioner
—
KY
363LF0000X
Family Nurse Practitioner
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65927881 GROUP
—
KY
01
—
7100147130
MEDICAID PHYSICAL THERAPIST
KY
01
—
7100185740
MEDICAID NURSE PRACTITIONER
KY
01
—
80900186
MEDICAID PODIATRIST
KY
01
—
90008962
MEDICAID DME
KY
01
—
9590071800
MEDICAID PHYSICIAN ASSISTANT
KY
Enumeration date
05/16/2014
Last updated
08/26/2022
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