NPIMap

Organization Active NPI

Orthodyne, LLC

  • Physical Therapist
  • Campbellsville, KY
National Provider Identifier
1033289459
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
109-14-4092 Issued in KY
Legal business name
ORTHODYNE, LLC
Practice address
111 Well Park Lane
Suite 2
Campbellsville, KY 42718
Phone
(270) 789-6629
NPI assigned
Nov 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kyle Bryan SalsburyNPI 1780754101
Title
Owner
Phone
(279) 789-6629

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 109-14-4092 KY Primary

Addresses

Primary practice location

111 Well Park Lane
Suite 2
Campbellsville, KY 42718

Mailing address

PO Box 896
Winchester, KY 40392-0896
Phone (859) 737-0904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070504000171 KY Part B Supplier - Clinic/Group Practice 3971609165 Receives reassigned benefits from 3 practitioners
Practice locations: Campbellsville, KY

National Provider Directory

National Provider Directory
Tax ID family
Orthodyne LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

190 W 1st St
Ste 103
Campbellsville, KY 42718
Phone (270) 789-6629

111 Wellpark Ln
Ste 2
Campbellsville, KY 42718
Phone (270) 789-6629

8003 Vine Crest Ave
Ste 12
Louisville, KY 40222
Phone (502) 741-5354

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1033289459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 896",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403920896",
            "telephone_number": "859-737-0904",
            "fax_number": "859-737-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WELL PARK LANE",
            "address_2": "SUITE 2",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "42718",
            "telephone_number": "270-789-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODYNE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "SALSBURY",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "279-789-6629"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "109-14-4092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbellsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.