NPIMap

Organization Active NPI

Danville Orthopaedics & Sports Medicine, PSC

  • Orthopaedic Surgery Physician
  • Danville, KY
National Provider Identifier
1477547073
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
DANVILLE ORTHOPAEDICS & SPORTS MEDICINE, PSC
Practice address
333 S 3Rd St
Suite B
Danville, KY 40422
Phone
(859) 236-8730
Fax
(859) 236-4468
NPI assigned
Sep 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Authorized official

Name
Angellina M Claunch
Title
Credentialing & Billing
Phone
(859) 209-4398

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Durable Medical Equipment & Medical Supplies 332B00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

333 S 3Rd St
Suite B
Danville, KY 40422

Mailing address

333 S 3Rd St
Suite B
Danville, KY 40422-2016
Phone (859) 236-8730

Other identifiers 2

IdentifierTypeStateIssuer
7100224350MedicaidKY
65911299MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040812000760 KY Part B Supplier - Clinic/Group Practice 3971575515 Receives reassigned benefits from 12 practitioners
Practice locations: Danville, KY
O20100930015020 KY DME Supplier - Physician - Orthopedic/Orthopedic Surgery 3971575515 Practice locations: Danville, KY

National Provider Directory

National Provider Directory

Locations

321 S 3rd St
Ste B
Danville, KY 40422
Phone (859) 236-7012

333 S 3rd St
Ste B
Danville, KY 40422
Phone (859) 236-8730

92 Joe T Petty Dr
Ste 300400
Russell Springs, KY 42642

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668124800000",
    "number": "1477547073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S 3RD ST",
            "address_2": "SUITE B",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404222016",
            "telephone_number": "859-236-8730",
            "fax_number": "859-236-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S 3RD ST",
            "address_2": "SUITE B",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "40422",
            "telephone_number": "859-236-8730",
            "fax_number": "859-236-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANVILLE ORTHOPAEDICS & SPORTS MEDICINE, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-09",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A",
        "authorized_official_last_name": "CLAUNCH",
        "authorized_official_first_name": "ANGELLINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING & BILLING",
        "authorized_official_telephone_number": "859-209-4398"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100224350",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65911299",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.