| Orthocincy Orthopaedics & Sports Medicine | |
|
560 S Loop Rd Edgewood KY 41017 | |
| (859) 301-2663 | |
| (859) 301-0655 |
| Full Name | Orthocincy Orthopaedics & Sports Medicine |
|---|---|
| Speciality | Orthopaedic Surgery |
| Location | 560 S Loop Rd, Edgewood, Kentucky |
| Authorized Official Name and Position | Joann M Reis (EXECUTIVE OFFICER/MANAGER) |
| Authorized Official Contact | 8598177070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orthocincy Orthopaedics & Sports Medicine 560 S Loop Rd Edgewood KY 41017-3405 Ph: (859) 301-2663 | Orthocincy Orthopaedics & Sports Medicine 560 S Loop Rd Edgewood KY 41017 Ph: (859) 301-2663 |
| NPI Number | 1598714560 |
|---|---|
| Provider Enumeration Date | 05/08/2006 |
| Last Update Date | 08/23/2022 |
| Medicare PECOS PAC ID | 3173500196 |
|---|---|
| Medicare Enrollment ID | O20040707000498 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598714560 | NPI | - | NPPES |
| 80900186 | Other | KY | MEDICAID PODIATRIST |
| 7100185740 | Other | KY | MEDICAID NURSE PRACTITIONER |
| 90008962 | Other | KY | MEDICAID DME |
| 9590071800 | Other | KY | MEDICAID PHYSICIAN ASSISTANT |
| 7100147130 | Other | KY | MEDICAID PHYSICAL THERAPIST |
| 65927881 | Medicaid | KY |
| Provider Name | Matthew T Desjardins |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1699777847 PECOS PAC ID: 2062484876 Enrollment ID: I20040811001176 |
| Provider Name | David Alexander Boyce |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720033533 PECOS PAC ID: 4789656307 Enrollment ID: I20040812000618 |
| Provider Name | Andrew William Koch |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1407839582 PECOS PAC ID: 4880612308 Enrollment ID: I20051229000143 |
| Provider Name | Matthew S Grunkemeyer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1457328676 PECOS PAC ID: 3476562000 Enrollment ID: I20060411000050 |
| Provider Name | David P Rhoads |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1992852909 PECOS PAC ID: 2365543352 Enrollment ID: I20070720000243 |
| Provider Name | Lisa Stroud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497802276 PECOS PAC ID: 4789772781 Enrollment ID: I20071108000260 |
| Provider Name | Kelly Rae Heisler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699846139 PECOS PAC ID: 5395834923 Enrollment ID: I20080103000123 |
| Provider Name | Nicholas M Mai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598937229 PECOS PAC ID: 5597839035 Enrollment ID: I20080801000231 |
| Provider Name | Trevor W Wilkes |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972724755 PECOS PAC ID: 8820162720 Enrollment ID: I20080811000056 |
| Provider Name | Jill B Goodwin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689601676 PECOS PAC ID: 9931110418 Enrollment ID: I20080820000663 |
| Provider Name | Matthew T Hummel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1881612679 PECOS PAC ID: 5496813248 Enrollment ID: I20081022000582 |
| Provider Name | James D Baker |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1588879860 PECOS PAC ID: 1557417771 Enrollment ID: I20090914000109 |
| Provider Name | Jennifer L Hensley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659502144 PECOS PAC ID: 8224174446 Enrollment ID: I20091001000381 |
| Provider Name | James T Bilbo |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1841295656 PECOS PAC ID: 4486793312 Enrollment ID: I20091205000008 |
| Provider Name | Nicholas T Gates |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164424313 PECOS PAC ID: 7113066044 Enrollment ID: I20091205000012 |
| Provider Name | Matthew J Connolly |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1023010279 PECOS PAC ID: 1759294168 Enrollment ID: I20091205000077 |
| Provider Name | Bruce R Holladay |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548262793 PECOS PAC ID: 7113066051 Enrollment ID: I20091205000113 |
| Provider Name | Richard M Hoblitzell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164428421 PECOS PAC ID: 0749329688 Enrollment ID: I20091205000132 |
| Provider Name | Thomas M Due |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1831194638 PECOS PAC ID: 9830238781 Enrollment ID: I20091205000142 |
| Provider Name | Forest T Heis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073518874 PECOS PAC ID: 5698815181 Enrollment ID: I20091214000534 |
| Provider Name | Charles Whalen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922173814 PECOS PAC ID: 6507750635 Enrollment ID: I20100109000371 |
| Provider Name | Raymond M Greiwe |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376754671 PECOS PAC ID: 6800080029 Enrollment ID: I20101102000600 |
| Provider Name | Angel L Velazquez-santiago |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629217880 PECOS PAC ID: 5890975684 Enrollment ID: I20110211000008 |
| Provider Name | Julie D Piscitello |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1124260658 PECOS PAC ID: 0547309650 Enrollment ID: I20110621000202 |
| Provider Name | Mathew T. Phillips |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1619172947 PECOS PAC ID: 8729256284 Enrollment ID: I20110727000738 |
| Provider Name | Shawn L Price |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1902023278 PECOS PAC ID: 5496948648 Enrollment ID: I20110926000813 |
| Provider Name | Brandon Patrick Griffin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063789931 PECOS PAC ID: 7719144229 Enrollment ID: I20120209000791 |
| Provider Name | Jared Cole Wilburn |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760704431 PECOS PAC ID: 0840453239 Enrollment ID: I20120522001238 |
| Provider Name | Adam V Metzler |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1841489259 PECOS PAC ID: 6305088717 Enrollment ID: I20130814001043 |
| Provider Name | Bradley S Dunkin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942499355 PECOS PAC ID: 0143464297 Enrollment ID: I20130911000784 |
| Provider Name | Lesley J Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376793349 PECOS PAC ID: 6800937020 Enrollment ID: I20140211001241 |
| Provider Name | Suzanne Dorma |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336210046 PECOS PAC ID: 1254330053 Enrollment ID: I20140314001301 |
| Provider Name | Joshua Aaron Deloriea |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285944124 PECOS PAC ID: 3779714795 Enrollment ID: I20140314001586 |
| Provider Name | Robert S Jolson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1225084593 PECOS PAC ID: 2961316906 Enrollment ID: I20140424001817 |
| Provider Name | John Brian Jacquemin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1316993686 PECOS PAC ID: 0840275954 Enrollment ID: I20150206000296 |
| Provider Name | Sara Ann Klar |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699166983 PECOS PAC ID: 1456677269 Enrollment ID: I20150312002186 |
| Provider Name | Jonathon M Spanyer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1770726481 PECOS PAC ID: 6507088325 Enrollment ID: I20150804004226 |
| Provider Name | Charles Roberts |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1366456162 PECOS PAC ID: 4789700782 Enrollment ID: I20151021001057 |
| Provider Name | Kathryn E Schwegmann |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306028717 PECOS PAC ID: 0547342305 Enrollment ID: I20151116001239 |
| Provider Name | Rebecca E. Popham |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1629377411 PECOS PAC ID: 6709025067 Enrollment ID: I20151222002151 |
| Provider Name | Howard Joseph Schertzinger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992797922 PECOS PAC ID: 7719911486 Enrollment ID: I20160105002567 |
| Provider Name | Stephen Louis Goldstein |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700902673 PECOS PAC ID: 8820393234 Enrollment ID: I20160223001879 |
| Provider Name | Kendra J Weisbrod |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831546498 PECOS PAC ID: 9931494077 Enrollment ID: I20160829000648 |
| Provider Name | Matthew L Stevens |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1003359043 PECOS PAC ID: 4284915950 Enrollment ID: I20170111003593 |
| Provider Name | Ronald T Auer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1174848196 PECOS PAC ID: 4880915016 Enrollment ID: I20170322001320 |
| Provider Name | Joshua Coger |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1043629439 PECOS PAC ID: 2365711207 Enrollment ID: I20170707002008 |
| Provider Name | Logan J Siemer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073048278 PECOS PAC ID: 6507138526 Enrollment ID: I20170824003307 |
| Provider Name | Renee N Rodgers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457889073 PECOS PAC ID: 5799059465 Enrollment ID: I20170919001322 |
| Provider Name | Timothy Burns |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1265790299 PECOS PAC ID: 0446499388 Enrollment ID: I20171004002443 |
| Provider Name | Jonathan B Slaughter |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1770876823 PECOS PAC ID: 0648576785 Enrollment ID: I20171115002225 |
| Provider Name | Ryan P Finnan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1366576233 PECOS PAC ID: 6305960048 Enrollment ID: I20180118002060 |
| Provider Name | Samantha Jo Mccracken |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285076901 PECOS PAC ID: 6709029952 Enrollment ID: I20180319002583 |
| Provider Name | Ana C Baptista-wise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366994048 PECOS PAC ID: 2567718356 Enrollment ID: I20180710000588 |
| Provider Name | Tyler James Keller |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1669738506 PECOS PAC ID: 5597996884 Enrollment ID: I20180827002448 |
| Provider Name | Andrea Marie Holliday |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1548268568 PECOS PAC ID: 8628014180 Enrollment ID: I20190531001362 |
| Provider Name | Roman Trimba |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1225393747 PECOS PAC ID: 6507094273 Enrollment ID: I20190625001862 |
| Provider Name | Pamela M Shepherd |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730747098 PECOS PAC ID: 5496089302 Enrollment ID: I20190626003703 |
| Provider Name | William Wallace Mcclellan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285070771 PECOS PAC ID: 1456593193 Enrollment ID: I20190627002248 |
| Provider Name | Brandon J Kohrs |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548675853 PECOS PAC ID: 3971826504 Enrollment ID: I20190731003460 |
| Provider Name | Emily N Rolf |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215596895 PECOS PAC ID: 5294063202 Enrollment ID: I20190828001852 |
| Provider Name | Gregory Ross Mccullough |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568941813 PECOS PAC ID: 2264781343 Enrollment ID: I20191029001592 |
| Provider Name | Christopher Swift |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417599820 PECOS PAC ID: 1850724014 Enrollment ID: I20191203000936 |
| Provider Name | Brian Andrew Wissel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386082915 PECOS PAC ID: 7113169186 Enrollment ID: I20191204001516 |
| Provider Name | James Trevor Stefanski |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093135907 PECOS PAC ID: 7416171343 Enrollment ID: I20200102000219 |
| Provider Name | Gina M Schuler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669019535 PECOS PAC ID: 8921434085 Enrollment ID: I20200207002149 |
| Provider Name | Robert Neltner |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316982788 PECOS PAC ID: 8820009301 Enrollment ID: I20200208000029 |
| Provider Name | Maria E Beane |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871045013 PECOS PAC ID: 4688924897 Enrollment ID: I20200506000542 |
| Provider Name | Maria J Reitzes |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972128403 PECOS PAC ID: 9931521911 Enrollment ID: I20200619002031 |
| Provider Name | Christine Hendron |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1366069619 PECOS PAC ID: 7012330632 Enrollment ID: I20200714003653 |
| Provider Name | Suresh Nayak |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730184946 PECOS PAC ID: 5395773071 Enrollment ID: I20201215002369 |
| Provider Name | Christopher Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699364190 PECOS PAC ID: 8022422187 Enrollment ID: I20210201001537 |
| Provider Name | John Lloyd Fritch |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679960843 PECOS PAC ID: 2567774276 Enrollment ID: I20210507001916 |
| Provider Name | Jeffrey Clark Wera |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700273356 PECOS PAC ID: 6305267592 Enrollment ID: I20210512001089 |
| Provider Name | Patrick James Messerschmitt |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1740491273 PECOS PAC ID: 7416126107 Enrollment ID: I20210630003506 |
| Provider Name | Jared Allen Blank |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316513526 PECOS PAC ID: 2668874058 Enrollment ID: I20210707003415 |
| Provider Name | Noah James Brueckner |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1326613670 PECOS PAC ID: 4981006855 Enrollment ID: I20210714003343 |
| Provider Name | Amelia J Wiggins |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407099195 PECOS PAC ID: 0648491688 Enrollment ID: I20220225002307 |
| Provider Name | Sean Thomas Molloy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992450704 PECOS PAC ID: 6305232844 Enrollment ID: I20220408001093 |
| Provider Name | Meg S Liter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1891424222 PECOS PAC ID: 9537549902 Enrollment ID: I20220630002681 |
| Provider Name | Faith C Roaden |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306584560 PECOS PAC ID: 0840670147 Enrollment ID: I20220705000755 |
| Provider Name | Shankar Narayanan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1659727121 PECOS PAC ID: 4385923903 Enrollment ID: I20220801001324 |
| Provider Name | Jordan M Maxwell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942949029 PECOS PAC ID: 8921481144 Enrollment ID: I20220819001706 |
| Provider Name | Benjamin J Valley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1295199131 PECOS PAC ID: 8820381387 Enrollment ID: I20221006001375 |
| Provider Name | Staci L Ames |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1427212232 PECOS PAC ID: 6002163250 Enrollment ID: I20221119000515 |
| Provider Name | Jordan T Barker |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295277358 PECOS PAC ID: 5597031898 Enrollment ID: I20230201001689 |
| Provider Name | Carla Jane Kramer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346956265 PECOS PAC ID: 6204209901 Enrollment ID: I20230228001228 |
| Provider Name | Hannah Tomko Bundus |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265138044 PECOS PAC ID: 3173996667 Enrollment ID: I20230303000607 |
| Provider Name | Alexandra Kleynenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477252807 PECOS PAC ID: 7810361631 Enrollment ID: I20230410000302 |
| Provider Name | Emily Michelle Dean |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871286450 PECOS PAC ID: 8224496880 Enrollment ID: I20230614002317 |
| Provider Name | Lauren A Protzer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1245762814 PECOS PAC ID: 3577814482 Enrollment ID: I20230616002512 |
| Provider Name | Chad Ryan Michels |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1326731852 PECOS PAC ID: 4183082472 Enrollment ID: I20230619000887 |
| Provider Name | Garret L Phipps |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922682277 PECOS PAC ID: 7214323054 Enrollment ID: I20230706002602 |
| Provider Name | Matthew Mathos |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285126698 PECOS PAC ID: 4284986514 Enrollment ID: I20230719001012 |
| Provider Name | Camryn Joanna Diebold |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497433387 PECOS PAC ID: 0345601266 Enrollment ID: I20230725002258 |
| Provider Name | Stephanie Leach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225402423 PECOS PAC ID: 7113221169 Enrollment ID: I20230816002035 |
| Provider Name | Holly Allyse Kallmeyer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336825249 PECOS PAC ID: 0042672347 Enrollment ID: I20230818000629 |
Infectious Disease Consultants Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 20 Medical Village Dr, Suite 355, Edgewood, KY 41017 Phone: 859-344-1512 Fax: 859-331-3698 | |
Alternative And Integrative Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Medical Village Dr, Edgewood, KY 41017 Phone: 859-341-2044 | |
St. Elizabeth Center For Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 413 S Loop Rd, Edgewood, KY 41017 Phone: 859-301-3800 Fax: 859-301-3987 | |
Premier Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 830 Thomas More Pkwy, Ste 203, Edgewood, KY 41017 Phone: 859-341-5757 Fax: 859-331-4757 |