Organization
ORTHOCINCY ORTHOPAEDICS & SPORTS MEDICINE PSC
Active
Other names
OrthoCincy Orthopaedics & Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
JOANN M REIS C.E.O. (EXECUTIVE OFFICER/MANAGER)
(859) 817-7070
Entity
Organization
Contact information
Practice address
560 S LOOP RD, EDGEWOOD, KY 41017
(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
—
—
207R00000X
Internal Medicine Physician
—
KY
207RM1200X
Magnetic Resonance Imaging (MRI) Internal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
KY
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
225100000X
Physical Therapist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
KY
363LF0000X
Family Nurse Practitioner
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65927881
—
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
05/08/2006
Last updated
08/23/2022
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