DR. JAMES W RICE MD
NPI 1265509285
Orthopaedic Surgery in Winchester, KY

Q: What is James Rice's NPI number?

The NPI number for James Rice is 1265509285. It was assigned to this individual provider in the NPPES registry on November 29, 2006.

Q: What is James Rice's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for James Rice was last updated on May 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 29, 2006PECOS EnrolledAccepts Medicare Assignment

0/100

CMS Quality Rating

404 SHOPPERS DR, WINCHESTER, KY 40391(859) 737-5333(859) 737-0070 Get Directions Write a Review

NPPES record last updated: May 16, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 16, 2025, Feb 6, 2025, Nov 5, 2024 and 5 more (8 updates tracked since 2018).

On this page

About Dr. James W Rice Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JAMES W RICE MD (NPI 1265509285) is an individual orthopaedic surgery provider in Winchester, Kentucky, licensed in Kentucky (45665) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, is affiliated with St Claire Regional Medical Center, and is a graduate of University Of Louisville School Of Medicine (2006).

NPPES Registry Identity

NPI1265509285

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. JAMES W RICECredential: MD

Location Address404 SHOPPERS DRWinchester, KY 40391-1301

Mailing Address404 Shoppers DrWinchester, KY 40391-1301 · (859) 737-5333 · Fax (859) 737-0070

Phone(859) 737-5333

Fax(859) 737-0070

Sole ProprietorNo

Medical School CMSUniversity Of Louisville School Of MedicineGraduated 2006

Enumeration DateNovember 29, 2006

Last NPPES UpdateMay 16, 20258 updates tracked since enumeration

NPPES CertifiedMay 16, 2025

✔ NPI 1265509285 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in KY · 45665

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

404 SHOPPERS DR, Winchester, KY 40391

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Other Identifiers 1

Medicaid7100230670KY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. James W Rice Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5496924342

PECOS Enrollment IDI20120824000068, I20130627000797

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 25

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

218 services158 patients

Injection of substance into lower spine canal using imaging guidance 62323

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

215 services143 patients

Mri scan of lower spinal canal without contrast 72148

An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.

97 services96 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level 64493

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

80 services60 patients

Injection of lower or sacral spine facet joint using imaging guidance, second level 64494

This procedure involves injecting medication into the facet joints of your lower or sacral spine to manage pain. Imaging guidance ensures accurate placement. It's the second level, meaning it's done on two different joint levels.

80 services60 patients

Injection, methylprednisolone acetate, 80 mg J1040

Methylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.

55 services47 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level 64483

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

51 services39 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint 64635

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

46 services35 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint 64636

This procedure involves using imaging technology to locate and treat nerves in your lower spine or sacral area that may be causing pain. Each additional facet joint refers to treating more than one spinal nerve. It's a non-invasive way to manage chronic back pain.

46 services35 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

46 services42 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

45 services41 patients

Injection, methylprednisolone acetate, 40 mg J1030

Methylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.

42 services34 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

30 services30 patients

Mri scan of upper spinal canal without contrast 72141

An MRI scan of the upper spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your upper spine. This helps doctors identify issues such as injuries, infections or diseases. No dye is used.

28 services28 patients

Mri scan of lower spinal canal before and after contrast 72158

An MRI scan of the lower spinal canal with contrast is a non-invasive imaging procedure. It uses magnetic fields to generate detailed images of your lower spine. A contrast agent is injected to enhance these images, helping doctors see issues more clearly.

26 services26 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

24 services22 patients

Testing for presence of drug, read by direct observation 80305

Testing for the presence of drugs involves collecting a sample, usually urine, which is then analyzed for specific substances. The process is monitored directly to ensure accuracy and integrity. This test helps to confirm if drugs are present in your system.

23 services23 patients

Insertion of cage or mesh device to spine bone and disc space during spine fusion 22853

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

22 services14 patients

Injection of substance into middle or upper spine canal using imaging guidance 62321

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

21 services18 patients

X-ray of upper spine, 2-3 views 72040

An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.

21 services20 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

20 services20 patients

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment 63047

This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

14 services14 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level 64484

This procedure involves injecting an anesthetic or steroid drug into the sacral spine nerve root. It's done under imaging guidance to ensure accuracy. The process can be repeated for each additional level of the spine to help manage pain or inflammation.

14 services12 patients

Mri scan of middle spinal canal without contrast 72146

An MRI scan of the middle spinal canal without contrast is a non-invasive imaging test. It uses magnetic fields and radio waves to create detailed images of your spine. This helps doctors identify any abnormalities or issues in your spinal canal. No dye is used in this procedure.

13 services13 patients

Injection of anesthetic agent and/or steroid into lower back and leg nerve (sciatic nerve) 64445

This procedure involves injecting an anesthetic or steroid into the lower back and leg nerve to alleviate pain. The injection helps reduce inflammation and numb the area, providing relief from discomfort. This is a common treatment for conditions such as sciatica and herniated discs.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Claire Regional Medical Center

Acute Care Hospitals · Morehead, KY

3/5 CMS rating

OwnershipGovernment - Federal

CMS Certification Number180018

Location222 Medical CircleMorehead, KY 40351 · Rowan County

Emergency services Birthing friendly

Baptist Health Richmond

Acute Care Hospitals · Richmond, KY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180049

Location801 Eastern BypassRichmond, KY 40475 · Madison County

Emergency services Birthing friendly

Saint Joseph Mount Sterling

Acute Care Hospitals · Mount Sterling, KY

OwnershipVoluntary non-profit - Private

CMS Certification Number180064

Location225 Falcon DriveMount Sterling, KY 40353 · Montgomery County

Emergency services Birthing friendly

Clark Regional Medical Center

Acute Care Hospitals · Winchester, KY

3/5 CMS rating

OwnershipProprietary

CMS Certification Number180092

Location175 Hospital DriveWinchester, KY 40391 · Clark County

Emergency services Birthing friendly

Baptist Health Lexington

Acute Care Hospitals · Lexington, KY

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number180103

Location1740 Nicholasville RoadLexington, KY 40503 · Fayette County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40391 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$66.24 typical visit price

range $16.53 – $131.99

Typical copayment $16.56 (range $4.13 – $32.99)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

0/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) A4595

DME-Other DME · category DE000N

1 supplier12 claims12 services$17.01 avg. paid by Medicare

Transport chair, adult size, patient weight capacity up to and including 300 pounds E1038

DME-Other DME · category DE000N

1 supplier15 claims15 services$10.64 avg. paid by Medicare

Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf L0642

DME-Orthotic Devices · category DF007N

1 supplier36 claims36 services$277.64 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KENTUCKY ORTHOPAEDICS & SPINE PLLC

Durable Medical Equipment & Medical Supplies