Courtney M Collien

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

5691 Issued in WI

Practice address

889 E Johnson St
Fond Du Lac, WI 54935-2933

Phone

(920) 367-6700

NPI assigned

Feb 19, 2014

Last updated

Dec 14, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Courtney M Leiteritz Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Froedtert Manitowoc Medical Group, LLCGroup PAC ID 2365836954, 156 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Family Memorial Hospital, Manitowoc, WI, CCN 520107

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ccollien655824@direct.froedtert.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Froedtert Manitowoc Medical Group, LLC

  dba Froedtert Northeast Medical Group

  • Multi-Specialty Clinic/Center
  • Manitowoc, WI
  • NPI 1437829975
  Medicare reassignment Care Compare group NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holy Family Memorial Inc

  dba Froedtert Holy Family Memorial Hospital

  • General Acute Care Hospital
  • Manitowoc, WI
  • NPI 1700998697
  Care Compare affiliation

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1124443726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 JACKSON ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549011513",
            "telephone_number": "920-223-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 E JOHNSON ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549352933",
            "telephone_number": "920-367-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIEN",
        "first_name": "COURTNEY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-19",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "166270",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "5691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "LEITERITZ",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Clinic of Orthopedic Surgery CHTD
• Kari Cobb, L.AC., DACM
• Aleshia M Cole, NP
• Meghan Renee Cole, LPC, CSAC
• Alexandra N Collard, PMHNP-BC
• Margaret Lynn Collien, CCSH
• Derek I Colmenares, MD
• Rosonna Sue Comers, LCSW CADCIII
• Companion Care & Transportation LLC
• Julia Condon, PHARMD

• Adult Health Nurse Practitioner in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Adult Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.

Verify at the official NPI Registry.