MEDICARE: ELLIS & BADENHAUSEN ORTHOPAEDICS, PSC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1477187920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELLIS & BADENHAUSEN ORTHOPAEDICS, PSC

Provider Business Mailing Address
First Line	:	PO BOX 32486
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40232-2486
Country	:	US
Telephone Number	:	502-587-1236
Fax Number	:	502-587-0126

Provider Business Practice Location Address
First Line	:	6768 BARDSTOWN RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40291-3048
Country	:	US
Telephone Number	:	502-587-1236
Fax Number	:

Authorized Official
Title or Position	:	BILLING DIRECTOR
Name	:	TASHANA M PRESTON
Credential	:	CPC
Telephone Number	:	502-587-1236

Provider Enumeration Date	:	02/24/2020
Last Update Date	:	02/27/2025

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Directions to “ELLIS & BADENHAUSEN ORTHOPAEDICS, PSC ” Practice Location

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