Organization
BLUEGRASS ORTHOPAEDICS PSC
Active
Organization
BLUEGRASS ORTHOPAEDICS PSC
Active
Other names
Bluegrass Orthopaedics
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY L D'ANGELO MD (PRESIDENT)
(859) 263-5140
Entity
Organization
Contact information
Practice address
3480 YORKSHIRE MEDICAL PARK, LEXINGTON, KY 40509
(859) 263-5140
(859) 263-5141
Mailing address
3480 YORKSHIRE MEDICAL PARK, LEXINGTON, KY 40509-1886
(859) 263-5140
(859) 263-5141
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100391600
—
KY
05
—
7100391610
—
KY
01
—
7100442680
MEDICAID DME
KY
05
—
7100459980
—
KY
05
—
7100462920
—
KY
05
—
7100462960
—
KY
05
—
7100552560
—
KY
Enumeration date
10/30/2015
Last updated
08/22/2019
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