CHARLES RYAN LEIBOLD MD
NPI 1316798945
Student in an Organized Health Care Education/Training Program in Lexington, KY

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since April 01, 2024PECOS Enrolled

110 CONN TER STE 550, LEXINGTON, KY 40508(859) 218-2631 Get Directions Write a Review

NPPES record last updated: April 1, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Charles Ryan Leibold Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLES RYAN LEIBOLD MD (NPI 1316798945) is an individual student in an organized health care education/training program in Lexington, Kentucky and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316798945

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameCHARLES RYAN LEIBOLDCredential: MD

Location Address110 CONN TER STE 550Lexington, KY 40508-3206

Mailing Address110 Conn Ter Ste 550Lexington, KY 40508-3206 · (859) 218-2631

Phone(859) 218-2631

Sole ProprietorNo

Enumeration DateApril 1, 2024

NPPES CertifiedMarch 31, 2024

✔ NPI 1316798945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

110 CONN TER STE 550, Lexington, KY 40508

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Charles Ryan Leibold Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CLAIRE ELIZABETH FRASER M.D., PH.D.

Ophthalmology (Retina Specialist)

110 CONN TER STE 550, UNIVERSITY OF KENTUCKY DEPT OF OPHTHALMOLOGY
LEXINGTON, KY 40508

Fayette County (859) 323-5867

SHEILA PLUMLEE SANDERS MD

Ophthalmology (Glaucoma Specialist)