NPIMap

Organization Active NPI

Kentucky Orthopaedics & Spine PLLC

  • Durable Medical Equipment & Medical Supplies
  • Versailles, KY
National Provider Identifier
1871267252
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
KENTUCKY ORTHOPAEDICS & SPINE PLLC
Practice address
360 Amsden Ave Ste 400
Versailles, KY 40383-1855
Phone
(859) 737-5333
Fax
(859) 737-0070
NPI assigned
Aug 9, 2021
Last updated
Sep 17, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
KENTUCKY ORTHOPAEDICS & SPINE PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Authorized official

Name
Joy Clevenger
Title
Credentialing Agent
Phone
(502) 523-6695

Specialties & licenses 1

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

Addresses

Primary practice location

360 Amsden Ave Ste 400
Versailles, KY 40383-1855

Mailing address

404 Shoppers Dr
Winchester, KY 40391-1301
Phone (859) 737-5333

Other identifiers 1

IdentifierTypeStateIssuer
7100794600MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211029001764 KY DME Supplier - Multi-Specialty - Physician 0749529097 Practice locations: Versailles, KY

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Kentucky Orthopaedics Spine PLLC5 organizations share this tax ID, including this one
Part of
Kentucky Orthopaedics Spine PLLC

Other organizations with this tax ID 4

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

Locations

235 Boggs Ln
Ste 7
Richmond, KY 40475
Phone (859) 625-9959

370 Amsden Ave
Ste 400
Versailles, KY 40383

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789603200000",
    "number": "1871267252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 SHOPPERS DR",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911301",
            "telephone_number": "859-737-5333",
            "fax_number": "859-737-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 AMSDEN AVE STE 400",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403831855",
            "telephone_number": "859-737-5333",
            "fax_number": "859-737-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY ORTHOPAEDICS & SPINE PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENTUCKY ORTHOPAEDICS & SPINE PLLC",
        "enumeration_date": "2021-08-09",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A",
        "authorized_official_last_name": "CLEVENGER",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "CREDENTIALING AGENT",
        "authorized_official_telephone_number": "502-523-6695"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100794600",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Versailles, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; 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.