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RYAN WILLIAM CLARK D.O. NPI 1720499759


NPI Information

NPI: 1720499759
Provider Name: RYAN WILLIAM CLARK, D.O.
Classification: Pain Medicine - 208VP0014X
Entity Type: Individual

Specialization: Interventional Pain Medicine

PECOS Registration: Yes

Address:
2845 GREENBRIER RD
GREEN BAY, WI
ZIP 54311
Phone: (920) 288-8377
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Ryan William Clark, D.O. is an interventional pain medicine pain medicine in Green Bay, WI with 11 years of experience. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. Ryan William Clark, D.O. NPI is 1720499759. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WESTERN UNIVERSITY OF HEALTH SCIENCES COLLEGE OF DENTAL MED
Graduation Year:2013

The provider's business location address is:

2845 GREENBRIER RD
GREEN BAY, WI
ZIP 54311-519
Phone: (920) 288-8377
Fax: (920) 288-8385

The NPI 1720499759 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Injection of substance into spinal canal of lower back or sacrum using imaging guidance (HCPCS:62323)
  • Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance (HCPCS:64483)
  • Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes (HCPCS:99152)
  • Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)
  • Destruction of lower or sacral spinal facet joint nerves using imaging guidance (HCPCS:64635)
  • Injections of lower or sacral spine facet joint using imaging guidance (HCPCS:64493)
  • Injections of lower or sacral spine facet joint using imaging guidance (HCPCS:64494)
  • Injection procedure into sacroiliac joint for anesthetic or steroid (HCPCS:27096)

The enumeration date for this NPI number is 5/13/2014 and was last updated on 5/25/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208100000XPhysical Medicine & Rehabilitation67188WISCONSINNo
2208VP0000XPain MedicinePain Medicine67188WISCONSINNo
3208VP0014XPain MedicineInterventional Pain Medicine67188WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1100068648MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.