NPIMap

Organization Active NPI

Orthocincy Orthopaedics & Sports Medicine PSC

  • Orthopaedic Surgery Physician
  • Florence, KY
National Provider Identifier
1396156972
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOCINCY ORTHOPAEDICS & SPORTS MEDICINE PSC
Practice address
8726 US 42
Florence, KY 41042
Phone
(859) 301-2663
Fax
(859) 301-0655
NPI assigned
May 16, 2014
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
Ceo/Manager
Phone
(859) 817-7070

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X KY
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X KY
Magnetic Resonance Imaging (MRI) Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RM1200X KY
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X KY Primary
Orthopaedic Hand Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0106X KY
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X KY
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X KY
Durable Medical Equipment & Medical Supplies 332B00000X KY
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X KY
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X KY
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X KY

Addresses

Primary practice location

8726 US 42
Florence, KY 41042

Mailing address

560 S Loop Rd
Edgewood, KY 41017-3405
Phone (859) 301-2663

Other identifiers 6

IdentifierTypeStateIssuer
9590071800OtherKYMEDICAID PHYSICIAN ASSISTANT
7100185740OtherKYMEDICAID NURSE PRACTITIONER
7100147130OtherKYMEDICAID PHYSICAL THERAPIST
90008962OtherKYMEDICAID DME
65927881 GROUPMedicaidKY
80900186OtherKYMEDICAID PODIATRIST

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150806011025 KY DME Supplier - Physician - Orthopedic/Orthopedic Surgery 3173500196 Practice locations: Florence, 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

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 167

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

View all 167

NPI Registry JSON

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661472000000",
    "number": "1396156972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 S LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173405",
            "telephone_number": "859-301-2663",
            "fax_number": "859-301-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8726 US 42",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "41042",
            "telephone_number": "859-301-2663",
            "fax_number": "859-301-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOCINCY ORTHOPAEDICS & SPORTS MEDICINE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-16",
        "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": "CEO/MANAGER",
        "authorized_official_telephone_number": "859-817-7070",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207RM1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Magnetic Resonance Imaging (MRI)",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PHYSICIAN ASSISTANT",
            "identifier": "9590071800",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID NURSE PRACTITIONER",
            "identifier": "7100185740",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PHYSICAL THERAPIST",
            "identifier": "7100147130",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "90008962",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65927881 GROUP",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PODIATRIST",
            "identifier": "80900186",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.