NPIMap

Organization Active NPI

Orthocincy Orthopaedics & Sports Medicine PSC

  • Orthopaedic Surgery Physician
  • Crestview Hills, KY
National Provider Identifier
1154572022
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
28345 Issued in KY
Legal business name
ORTHOCINCY ORTHOPAEDICS & SPORTS MEDICINE PSC
Practice address
2845 Chancellor Dr
Crestview Hills, KY 41017
Phone
(859) 426-4200
Fax
(859) 426-4206
NPI assigned
Oct 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Authorized official

Name
Joann M. Reis, CEO
Title
Executive Officer
Phone
(859) 817-7070

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 28345 KY Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

2845 Chancellor Dr
Crestview Hills, KY 41017

Mailing address

560 South Loop Road
Edgewood, KY 41017-8010
Phone (859) 817-7070

Other identifiers 2

IdentifierTypeStateIssuer
65927881MedicaidKY
90008962MedicaidKY

Other names 1

  • OrthoCincy Orthopaedics & Sports Medicine Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930024383 KY DME Supplier - Physician - Orthopedic/Orthopedic Surgery 3173500196 Practice locations: Crestview Hills, KY

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2139730Orthocincy Orthopaedics & Sports Medicine2845 Chancellor Drive, Crestview Hills, KY 41017Certificate of waiverNov 6, 2027

National Provider Directory

National Provider Directory
Tax ID family
Orthocincy Orthopaedics Sports Medicine PSC17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Practitioners & affiliated clinicians

Practitioners 164

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

View all 164

NPI Registry JSON

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661472000000",
    "number": "1154572022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 SOUTH LOOP ROAD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410178010",
            "telephone_number": "859-817-7070",
            "fax_number": "859-817-7848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 CHANCELLOR DR",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "41017",
            "telephone_number": "859-426-4200",
            "fax_number": "859-426-4206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOCINCY ORTHOPAEDICS & SPORTS MEDICINE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-09",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A",
        "authorized_official_last_name": "REIS",
        "authorized_official_first_name": "JOANN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "859-817-7070",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": "28345",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65927881",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90008962",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OrthoCincy Orthopaedics & Sports Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Crestview Hills, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.