NPIMap

Organization Active NPI

Orthocincy Orthopaedics & Sports Medicine PSC

  • Orthopaedic Surgery Physician
  • Edgewood, KY
National Provider Identifier
1598714560
Registry record updated Aug 23, 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
560 S Loop Rd
Edgewood, KY 41017
Phone
(859) 301-2663
Fax
(859) 301-0655
NPI assigned
May 8, 2006
Last updated
Aug 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Authorized official

Name
Joann M Reis, C.E.O.
Title
Executive Officer/Manager
Phone
(859) 817-7070

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X
Nurse Practitioner 363L00000X KY
Family Nurse Practitioner 363LF0000X KY
Sports Medicine (Family Medicine) Physician 207QS0010X
Internal Medicine Physician 207R00000X KY
Magnetic Resonance Imaging (MRI) Internal Medicine Physician 207RM1200X
Orthopaedic Surgery Physician 207X00000X Primary
Orthopaedic Hand Surgery Physician 207XS0106X KY
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X
Physical Medicine & Rehabilitation Physician 208100000X
Podiatrist 213E00000X
Foot & Ankle Surgery Podiatrist 213ES0103X
Physical Therapist 225100000X

Addresses

Primary practice location

560 S Loop Rd
Edgewood, KY 41017

Mailing address

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

Other identifiers 6

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

Other names 1

  • OrthoCincy Orthopaedics & Sports Medicine Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH, IN4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20040707000498 KY Part B Supplier - Clinic/Group Practice 3173500196 Receives reassigned benefits from 140 practitioners
Practice locations: Louisville, KY; Williamstown, KY; Highland Heights, KY; Florence, KY; Edgewood, KY; Crestview Hills, KY
O20100930018795 KY DME Supplier - Physician - Orthopedic/Orthopedic Surgery 3173500196 Practice locations: Edgewood, KY
O20130522000662 OH Part B Supplier - Clinic/Group Practice 3173500196 Receives reassigned benefits from 110 practitioners
4 other NPIs on this enrollment
Practice locations: Cincinnati, OH; Montgomery, OH; West Chester, OH
O20190116003822 IN Part B Supplier - Clinic/Group Practice 3173500196 Receives reassigned benefits from 35 practitioners
Practice locations: Lawrenceburg, IN; New Albany, IN; Greendale, IN

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

Locations

2626 Alexandria Pike
Ste 100
Highland Heights, KY 41076
Phone (859) 817-3599

2626 Alexandria Pike Ste 100
Southgate, KY 41071

Dept L700
Cincinnati, OH 45270

9871 Montgomery Rd
Montgomery, OH 45242

Practitioners & affiliated clinicians

Practitioners 218

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 218

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1598714560",
    "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": "560 S LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "41017",
            "telephone_number": "859-301-2663",
            "fax_number": "859-301-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOCINCY ORTHOPAEDICS & SPORTS MEDICINE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "REIS",
        "authorized_official_first_name": "JOANN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE OFFICER/MANAGER",
        "authorized_official_telephone_number": "859-817-7070",
        "authorized_official_credential": "C.E.O."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207RM1200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID NURSE PRACTITIONER",
            "identifier": "7100185740",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PODIATRIST",
            "identifier": "80900186",
            "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",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PHYSICIAN ASSISTANT",
            "identifier": "9590071800",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OrthoCincy Orthopaedics & Sports Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Edgewood, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.