NPIMap

Organization Active NPI

Ellis & Badenhausen Orthopaedics, PSC

  • Durable Medical Equipment & Medical Supplies
  • Louisville, KY
National Provider Identifier
1336244789
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0643220001 Issued in KY
Legal business name
ELLIS & BADENHAUSEN ORTHOPAEDICS, PSC
Practice address
13151 Magisterial Dr
Suite 200
Louisville, KY 40223-4103
Phone
(502) 587-1236
Fax
(502) 587-0126
NPI assigned
Sep 13, 2006
Last updated
Feb 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Authorized official

Name
Tashana M Preston, CPC
Title
Billing Director
Phone
(502) 587-1236

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0643220001 KY Primary

Addresses

Primary practice location

13151 Magisterial Dr
Suite 200
Louisville, KY 40223-4103

Mailing address

PO Box 32486
Louisville, KY 40232-2486
Phone (502) 587-1236

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930058501 KY DME Supplier - Physician - Orthopedic/Orthopedic Surgery 9032104559 Practice locations: Louisville, 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
Tax ID family
Ellis Badenhausen PSC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

13151 Magisterial Dr
#200
Louisville, KY 40223

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1336244789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32486",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402322486",
            "telephone_number": "502-587-1236",
            "fax_number": "502-587-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13151 MAGISTERIAL DR",
            "address_2": "SUITE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234103",
            "telephone_number": "502-587-1236",
            "fax_number": "502-587-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS & BADENHAUSEN ORTHOPAEDICS, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "PRESTON",
        "authorized_official_first_name": "TASHANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "502-587-1236",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "0643220001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.