Camryn Joanna Diebold, PT, DPT

Individual provider Active NPI Physical Therapist · Edgewood, KY

NPI 1497433387 · NPPES record last updated Jul 17, 2023

Key facts

NPI
1497433387
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
008782 (KY)
Practice address
560 S Loop Rd
Edgewood, KY 41017-3405
Phone
(859) 301-2663
NPI assigned
Jul 10, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthocincy Orthopaedics and Sports Medicine PSC (163 clinicians)

Practice addresses (Care Compare)

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

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100 (apm)
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230725002258 KY Practitioner - Physical Therapist in Private Practice 0345601266 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocincy Orthopaedics & Sports Medicine PSC Physical Therapist Current
since Jul 17, 2023
Accepting new patients
Orthocincy Orthopaedics & Sports Medicine PSC Physical Therapist Current
since Jul 17, 2023
Accepting new patients

Locations

560 S Loop Rd
Edgewood, KY 41017
Phone (859) 817-3599

8726 Old US Highway 42
Florence, KY 41042

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 008782 KY Yes

Addresses

Primary practice location

560 S Loop Rd
Edgewood, KY 41017-3405

Mailing address

1204 Mockingbird CT
Edgewood, KY 41018-2609
Phone (859) 380-7117

Other practice location 1

8726 US 42
Florence, KY 41042
Phone (859) 301-2663

Other providers in Edgewood, KY

All providers in Edgewood, KY · Physical Therapist in Kentucky

Sources for this page

Verify at the official NPI Registry.