Healthcare Provider Details

I. General information

NPI: 1033358726
Provider Name (Legal Business Name): LEXINGTON PODIATRY PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2009
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 OLD ROSEBUD RD STE 250
LEXINGTON KY
40509-8625
US

IV. Provider business mailing address

2700 OLD ROSEBUD RD STE 250
LEXINGTON KY
40509-8625
US

V. Phone/Fax

Practice location:
  • Phone: 859-264-1141
  • Fax: 859-264-1963
Mailing address:
  • Phone: 859-264-1141
  • Fax: 859-264-1963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. NICOLE G FREELS
Title or Position: OWNER
Credential: DPM
Phone: 859-264-1141