Provider Demographics
NPI:1962855254
Name:COMMONWEALTH HAND THERAPY
Entity type:Organization
Organization Name:COMMONWEALTH HAND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:PITTS
Authorized Official - Suffix:
Authorized Official - Credentials:MS,OTR/L, CHT
Authorized Official - Phone:859-447-8600
Mailing Address - Street 1:330 WALLER AVE STE 275
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2930
Mailing Address - Country:US
Mailing Address - Phone:859-447-8600
Mailing Address - Fax:859-447-8599
Practice Address - Street 1:330 WALLER AVE STE 275
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504
Practice Address - Country:US
Practice Address - Phone:859-447-8600
Practice Address - Fax:859-447-8599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
KY225X00000X, 225XH1200X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100435040Medicaid
KY7100462090Medicaid
KYK212270Medicare PIN
KY7100435040Medicaid