NPIMap

Individual provider Active NPI

Clifford Ryan Kissling

  • Physical Medicine & Rehabilitation Physician
  • Muskogee, OK
National Provider Identifier
1548754344
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
39479 Issued in OK
Practice address
300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone
(918) 684-2420
Fax
(918) 502-7573
NPI assigned
Jun 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 2019019197 MO
Physical Medicine & Rehabilitation Physician 208100000X 39479 OK Primary

Addresses

Primary practice location

300 Rockefeller Dr
Muskogee, OK 74401-5075

Mailing address

6600 S Yale Ave Ste 1400
Tulsa, OK 74136-3331
Phone (918) 684-2420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, KS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220722002203 OK Practitioner - Physical Medicine and Rehabilitation 7719236421 Reassigns benefits to 1 organization
I20240903000308 KS Practitioner - Physical Medicine and Rehabilitation 7719236421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Kansas School of Med (KC/Wich/Sal), 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Hospitalists of Kansas LLCGroup PAC ID 6002040557, 23 clinicians

Practice addresses (Care Compare)

833 N Vassar Ave
Premier Physical Medicine and Rehab
Wichita, KS 67208-2906
Phone (316) 755-0144

Hospital & facility affiliations

  • Wesley Medical Center Hospital, Wichita, KS, CCN 170123
  • Ascension Via Christi Hospitals Wichita, Inc. Hospital, Wichita, KS, CCN 170122
  • Kansas Spine & Specialty Hospital, LLC Hospital, Wichita, KS, CCN 170196
  • Hutchinson Regional Medical Center Inc Hospital, Hutchinson, KS, CCN 170020
  • Via Christi Hospital Wichita St Teresa, Inc Hospital, Wichita, KS, CCN 170200
  • Wesley Medical Center,LLC Inpatient rehabilitation facility, Wichita, KS, CCN 17T123
  • Ascension Via Christi Rehabilitation Hospital, Inc Inpatient rehabilitation facility, Wichita, KS, CCN 173028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2019019197MOMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Hospitalists of Kansas, LLC CurrentSince Sep 1, 2024 Accepting new patients
Warren Clinic Inc CurrentSince Sep 1, 2022 Accepting new patients
Premier Hospitalists of Kansas, LLC Physical Medicine & Rehabilitation CurrentSince Sep 1, 2024 Accepting new patients
Saint Francis Hospital Muskogee Inc Past Accepting new patients

Locations

833 N Vassar Ave
Wichita, KS 67208
Phone (316) 771-4300

3515 W Central Ave
Wichita, KS 67203
Phone (316) 942-0119

1151 N Rock Rd
Wichita, KS 67206
Phone (316) 634-3400

550 N Hillside St
Wichita, KS 67214
Phone (316) 688-2239

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1548754344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363331",
            "telephone_number": "918-684-2420",
            "fax_number": "918-502-7573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ROCKEFELLER DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015075",
            "telephone_number": "918-684-2420",
            "fax_number": "918-502-7573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSLING",
        "first_name": "CLIFFORD",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-15",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2019019197",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OK",
            "license": "39479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.