Healthcare Provider Details

I. General information

NPI: 1649698523
Provider Name (Legal Business Name): RYAN THOMAS SANTIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2014
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 S 17TH ST STE 202
LINCOLN NE
68502-3763
US

IV. Provider business mailing address

2221 S 17TH ST STE 202
LINCOLN NE
68502-3763
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-8555
  • Fax: 402-483-8554
Mailing address:
  • Phone: 402-483-8555
  • Fax: 402-483-8554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number78371
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberT0918
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number14326
License Number StateND
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number32734
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: