Provider Demographics
NPI:1053494401
Name:WINEINGER, RYAN (OD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:WINEINGER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 QUIVIRA RD
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-3511
Mailing Address - Country:US
Mailing Address - Phone:913-645-0149
Mailing Address - Fax:
Practice Address - Street 1:7505 QUIVIRA RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66216-3501
Practice Address - Country:US
Practice Address - Phone:913-631-0090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1669152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSU97579Medicare UPIN
KSK258C30Medicare PIN