MEDICARE: KENTUCKIANA CENTER FOR BETTER BONE & JOINT HEALTH, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	363A00000X	Physician Assistant
3	363L00000X	Nurse Practitioner
4	207RR0500X	Rheumatology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	CG5039	OTHER	KY	RAILROAD MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922081546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENTUCKIANA CENTER FOR BETTER BONE & JOINT HEALTH, PLLC

Provider Business Mailing Address
First Line	:	100 E LIBERTY ST
Second Line	:	SUITE 700
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1426
Country	:	US
Telephone Number	:	502-583-5836
Fax Number	:	502-583-2266

Provider Business Practice Location Address
First Line	:	100 EAST LIBERTY STREET
Second Line	:	SUITE 700
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1426
Country	:	US
Telephone Number	:	502-583-5836
Fax Number	:	502-583-2266

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	STEVEN H. STERN
Credential	:	MD
Telephone Number	:	502-583-5836

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	04/24/2023

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