ORTHOCINCY ORTHOPAEDICS & SPORTS MEDICINE PSC

Provider Demographics

• NPI: 1942679915
• Name: ORTHOCINCY ORTHOPAEDICS & SPORTS MEDICINE PSC
• Entity Type: Organization
• Organization Name: ORTHOCINCY ORTHOPAEDICS & SPORTS MEDICINE PSC
• Other - Org Name: COMMONWEALTH ORTHOPAEDIC CENTERS, PSC
• Other - Org Type: Former Legal Business Name
• Authorized Official - Title/Position: CEO
• Authorized Official - First Name: JOANN
• Authorized Official - Middle Name: M
• Authorized Official - Last Name: REIS
• Authorized Official - Phone: 859-817-7070
• Mailing Address - Street 1: 560 S LOOP RD
• Mailing Address - City: EDGEWOOD
• Mailing Address - State: KY
• Mailing Address - Zip Code: 41017-3405
• Mailing Address - Country: US
• Mailing Address - Phone: 859-301-2663
• Mailing Address - Fax: 859-301-0655
• Practice Address - Street 1: 2123 AUBURN AVE
• Practice Address - Street 2: SUITE 630
• Practice Address - City: CINCINNATI
• Practice Address - State: OH
• Practice Address - Zip Code: 45219-2906
• Practice Address - Country: US
• Practice Address - Phone: 859-301-2663
• Practice Address - Fax: 859-301-0655
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2015-09-21
• Last Update Date: 2022-08-26

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207X00000X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery		Group - Multi-Specialty
No	207R00000X	Allopathic & Osteopathic Physicians	Internal Medicine		Group - Multi-Specialty
No	207XS0106X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery	Hand Surgery	Group - Multi-Specialty
No	207XS0114X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery	Adult Reconstructive Orthopaedic Surgery	Group - Multi-Specialty
No	207XS0117X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery	Orthopaedic Surgery of the Spine	Group - Multi-Specialty
No	207XX0004X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery	Foot and Ankle Surgery	Group - Multi-Specialty
No	207XX0005X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery	Sports Medicine	Group - Multi-Specialty
No	208100000X	Allopathic & Osteopathic Physicians	Physical Medicine & Rehabilitation		Group - Multi-Specialty
No	213E00000X	Podiatric Medicine & Surgery Service Providers	Podiatrist		Group - Multi-Specialty
No	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies		Group - Multi-Specialty
No	363A00000X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant		Group - Multi-Specialty
No	363AM0700X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant	Medical	Group - Multi-Specialty
No	363AS0400X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant	Surgical	Group - Multi-Specialty
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		Group - Multi-Specialty
No	363LF0000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Family	Group - Multi-Specialty