Active NPI
Ryan William Clark, D.O.
- Interventional Pain Medicine Physician
- Green Bay, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Pain Medicine Physician
- License
- 67188
- Practice address
- 2845 Greenbrier Rd
Green Bay, WI 54311-6519 - Phone
- (920) 288-8377
- Fax
- (920) 288-8385
- NPI assigned
- May 13, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine Physician | 208VP0000X | 67188 | WI | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 67188 | WI | |
| Interventional Pain Medicine Physician | 208VP0014X | 67188 | WI | Primary |
Addresses
Primary practice location
2845 Greenbrier Rd
Green Bay, WI 54311-6519
Mailing address
1035 Kepler Dr
Green Bay, WI 54311-8320
Phone (920) 288-8377
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100068648 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Pain Management
- Education
- Western University of Health Sciences College of Dental Med, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (920) 288-4930
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67188 | WI | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baycare Clinic LLP | Physical Medicine & Rehabilitation | Current | Accepting new patients |
| Aurora Advanced Healthcare, Inc. | Current | Accepting new patients | |
| Aurora Advanced Healthcare Inc | Current | Accepting new patients | |
| Baycare Clinic LLP | Current | Accepting new patients |
Locations
3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100
2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388
1035 Kepler Dr
Green Bay, WI 54311
2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400
1500 Arbor Way
Kaukauna, WI 54130
Phone (877) 229-2273
12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200
6425 W Mequon Rd
Mequon, WI 53092
Phone (262) 242-0051
719 Doctors Ct
Oshkosh, WI 54901
Phone (920) 235-0066
323 S 18th Ave
Sturgeon Bay, WI 54235
Phone (920) 743-5566
Interoperability endpoints
- rclark204581@direct.myadvocateaurora.org
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.
-
- Emergency Medicine Physician
- Green Bay, WI
- NPI 1588609648
Physical Medicine & Rehabilitation
-
- Family Medicine Physician
- Milwaukee, WI
- NPI 1265629133
-
- Durable Medical Equipment & Medical Supplies
- Summit, WI
- NPI 1477186633
-
- Durable Medical Equipment & Medical Supplies
- Manitowoc, WI
- NPI 1134490758
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Two Rivers, WI
- NPI 1477508687
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1255387726
-
- Critical Access Hospital
- Sturgeon Bay, WI
- NPI 1093743874
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776729600000",
"number": "1720499759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1035 KEPLER DR",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543118320",
"telephone_number": "920-288-8377",
"fax_number": "920-405-8005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2845 GREENBRIER RD",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543116519",
"telephone_number": "920-288-8377",
"fax_number": "920-288-8385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "RYAN",
"middle_name": "WILLIAM",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-13",
"last_updated": "2026-04-21",
"certification_date": "2026-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "WI",
"license": "67188",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "WI",
"license": "67188",
"primary": false
},
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "WI",
"license": "67188",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100068648",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.