Ryan J Lieske (NPI# 1821040536, PAC ID# 3678463320) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1821040536 |
| PAC ID by PECOS | 3678463320 |
| Professional Enrollment ID | I20040317000867 |
| Full Name | Ryan J Lieske |
| Organization Legal Name | RAVENNA MEDICAL CLINIC PC |
| Address |
104 W Seneca St Ravenna NE 68869-1363 |
| Phone Number | 3084523203 |
| Gender | M |
| Credential | PA |
| Graduation Year | 1997 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 0547536047 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 280061 | REGIONAL WEST MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 104 W Seneca St, Ravenna, NE 68869-1363 | 3084523203 | RAVENNA MEDICAL CLINIC PC |
| Organization Legal Name | RAVENNA MEDICAL CLINIC PC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Julie A Keaschall | Nurse Practitioner | Ravenna Medical Clinic PC | 104 W Seneca St, Ravenna, NE 68869-1363 |
| Street Address |
104 W SENECA ST |
| City | RAVENNA |
| State | NE |
| Zip | 68869-1363 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Julie A Keaschall | Nurse Practitioner | Ravenna Medical Clinic PC | 104 W Seneca St, Ravenna, NE 68869-1363 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tyler James Kowalski | Chiropractic | Kowalski Chiropractic Health and Performance LLC | 316 Grand Ave, Ravenna, NE 68869-1322 |
| City | RAVENNA |
| Zip Code | 68869 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | RAVENNA + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.