MEDICARE: KENTUCKY ORTHOPEDIC REHABILITATION, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	261QR0400X	Rehabilitation Clinic/Center
2	225X00000X	Occupational Therapist
3	225100000X	Physical Therapist
4	2251X0800X	Orthopedic Physical Therapist
5	261QP2000X	Physical Therapy Clinic/Center	KY

General Provider Information

NPI Number	:	1730189762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENTUCKY ORTHOPEDIC REHABILITATION, LLC

Provider Business Mailing Address
First Line	:	4714 GETTYSBURG RD
Second Line	:	LEGAL DEPARTMENT
City	:	MECHANICSBURG
State	:	PA
Zip	:	17055-4325
Country	:	US
Telephone Number	:	717-972-1100
Fax Number	:	717-975-9981

Provider Business Practice Location Address
First Line	:	1650 BRYAN STATION RD
Second Line	:	SUITE 122
City	:	LEXINGTON
State	:	KY
Zip	:	40505-2138
Country	:	US
Telephone Number	:	859-293-6133
Fax Number	:	859-293-6730

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	JOHN F DUGGAN
Credential	:
Telephone Number	:	717-972-1100

Provider Enumeration Date	:	08/01/2005
Last Update Date	:	10/17/2025

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