DR. JOHN RICHARD REISKYTL (NPI# 1841210150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841210150 |
| Entity Type | Individual |
| Full Name | DR. JOHN RICHARD REISKYTL |
| Credential | MD |
| Practice Address |
1205 North Ave Cleveland Va Cboc Cleveland WI 53015-1413 |
| Practice Telephone | 9206935600 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 30968 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
1205 NORTH AVE CLEVELAND VA CBOC |
| City | CLEVELAND |
| State | WI |
| Zip Code | 53015-1413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760807259 | Nathan Nitka | Dietitian, Registered | 1205 North Ave, Cleveland, WI 53015-1413 | 2014-02-20 |
| 1295060275 | Tao Lee | Nurse Practitioner | 1205 North Ave, Cleveland, WI 53015-1413 | 2009-10-08 |
| 1184860124 | Carrie Lynne Oakley | Registered Nurse | 1205 North Ave, Cleveland, WI 53015-1413 | 2008-12-22 |
| 1841496486 | Charlene Mae Baumgartner | Registered Nurse | 1205 North Ave, Cleveland, WI 53015-1413 | 2007-06-21 |
| 1013010024 | Amy Sue Mckenzie | Counselor | 1205 North Ave, Cleveland, WI 53015-1413 | 2006-09-06 |
| 1154337558 | Cleveland Va Cboc | Clinic/Center | 1205 North Ave, Cleveland, WI 53015-1413 | 2006-07-31 |
| 1417961590 | Jamie Lauren Olsen | Dietitian, Registered | 1205 North Ave, Cleveland, WI 53015-1413 | 2006-07-27 |
| 1174537245 | Sue E. Thobaben | Registered Nurse | 1205 North Ave, Cleveland, WI 53015-1413 | 2006-07-27 |
| 1255354064 | Carol Ilma Jacobs | Nurse Practitioner | 1205 North Ave, Cleveland, WI 53015-1413 | 2006-07-25 |
| 1881614683 | Agnes E Deehr | Licensed Practical Nurse | 1205 North Ave, Cleveland, WI 53015-1413 | 2006-07-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942392428 | Gary J Kunz | Nurse Practitioner | 1205 North Avenue, Cleveland, WI 53015 | 2006-09-29 |
| 1437611159 | Tss Equipment Company | Technician, Other | 14302 Pigeon River Rd, Cleveland, WI 53015-1158 | 2019-04-02 |
| 1023275013 | Lakeshore Community Dental Clinic | Clinic/Center | 1290 North Ave, Lakeshore Community Dental Clinic, Cleveland, WI 53015-1412 | 2008-05-19 |
| 1114290384 | Michelle Ann Hemb | Licensed Practical Nurse | 1345 W Washington Ave, Cleveland, WI 53015-1430 | 2012-02-17 |
| 1730653783 | Miranda Jost | Registered Nurse | N9548 Highway 42, Cleveland, WI 53015-1628 | 2019-01-13 |
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417577537 | Eduardo Trevino | Family Medicine | 3009 Midfield Cir Se, Cleveland, TN 37323-0554 | 2020-04-18 |
| 1518429240 | Care Alliance | Family Medicine | 4050 Superior Ave Fl 3, Cleveland, OH 44103-1128 | 2019-04-02 |
| 1659808236 | Tara K Iyer | Family Medicine | Women's Health Institute 9500 Euclid Ave A81, Cleveland, OH 44195-0001 | 2017-05-15 |
| 1972958072 | Matthew Novin | Family Medicine | 15105 St Clair Ave, Cleveland, OH 44110-1111 | 2016-04-27 |
| 1235519166 | Michelle Caster | Family Medicine | 11100 Euclid Ave # B200, Cleveland, OH 44106 | 2015-06-05 |
| 1437545720 | Keisha Danielle Sullivan | Family Medicine | 11100 Euclid Ave Fl Bolwell6, Cleveland, OH 44106 | 2015-04-13 |
| 1356747679 | Rmi Holding Corporation, Inc | Family Medicine | 3854 Candies Creek Ln Nw, Cleveland, TN 37312-1863 | 2014-11-13 |
| 1326450123 | Anna Camille Moreno | Family Medicine | 9500 Euclid Ave # A1-854, Cleveland, OH 44195-1101 | 2014-05-28 |
| 1568874816 | Garrett L Kirkpatrick | Family Medicine | The Cleveland Clinic Foundation 9500 Euclid Ave, Cleveland, OH 44195-4420 | 2014-05-21 |
| 1104250448 | Aaron Doss Samuel | Family Medicine | 3178 Chestnut Cir Nw, Cleveland, TN 37312-2137 | 2013-08-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.