NPIMap

Organization Active NPI

Kibbe Orthopedics PLLC

Doing business as Kentucky Orthopedics & Sports Medicine

  • Durable Medical Equipment & Medical Supplies
  • Mt Washington, KY
National Provider Identifier
1063192847
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
KIBBE ORTHOPEDICS PLLC
Doing business as
Kentucky Orthopedics & Sports Medicine
Practice address
209 High Point CT Ste 100
Mt Washington, KY 40047-5512
Phone
(502) 834-5676
Fax
(833) 700-1693
NPI assigned
Jul 18, 2023
Last updated
Jul 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Authorized official

Name
Dr. Shane Jacob Kibbe, MDNPI 1265708168
Title
Owner
Phone
(502) 834-5676

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
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

209 High Point CT Ste 100
Mt Washington, KY 40047-5512

Mailing address

PO Box 33149
Belfast, ME 04915-0609
Phone (888) 488-8289

Other names 2

  • Kentucky Orthopedics & Sports Medicine Doing business as
  • Kibbe Orthopedics, PLLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240429003617 KY DME Supplier - Physician - Orthopedic/Orthopedic Surgery 3375925670 Practice locations: Mount Washington, KY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

209 High Point Ct
Ste 100
Mt Washington, KY 40047
Phone (502) 834-5676

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26913/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1063192847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33149",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049150609",
            "telephone_number": "888-488-8289",
            "fax_number": "502-919-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 HIGH POINT CT STE 100",
            "city": "MT WASHINGTON",
            "state": "KY",
            "postal_code": "400475512",
            "telephone_number": "502-834-5676",
            "fax_number": "833-700-1693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIBBE ORTHOPEDICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "KIBBE",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-834-5676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kentucky Orthopedics & Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kibbe Orthopedics, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mt Washington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.