Callie Colwell, RN

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

259034 Issued in WI

Practice address

3825 39TH Ave Ste 120
Kenosha, WI 53144-2043

Phone

(629) 465-7522

NPI assigned

Nov 1, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Addiction Services and Pharmacotherapy, SC

  • Methadone Clinic
  • Kenosha, WI
  • NPI 1538820790
  NPD

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1003523705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 39TH AVE STE 120",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531442043",
            "telephone_number": "629-465-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 39TH AVE STE 120",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531442043",
            "telephone_number": "629-465-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLWELL",
        "first_name": "CALLIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "259034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherry M Clifton, PT
• Meredith Carter Clubb, M.D.
• Cmap, SC
• Emily Jane Collins, R.D.
• Jill Colontuono, NNP-BC, PNCB
• Comfort Care Home Health
• Comprehensive Orthopaedics SC
• Comprehensive Orthopaedics SC
• Debra Jean Conforti, L.P.N.
• Lisa Marie Conklyn, MS, CCC-SLP

• Addiction (Substance Use Disorder) Registered Nurse in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Addiction (Substance Use Disorder) Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.