Individual provider Active NPI

Carrie Elizabeth Colligan, PA-C

  • Physician Assistant
  • Green Bay, WI
National Provider Identifier
1558500116
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4265-23 Issued in WI
Practice address
1110 Kepler Dr
Green Bay, WI 54311-8306
Phone
(920) 288-5555
Fax
(920) 288-5550
NPI assigned
Feb 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4265-23 WI Primary

Addresses

Primary practice location

1110 Kepler Dr
Green Bay, WI 54311-8306

Mailing address

1035 Kepler Dr
Green Bay, WI 54311-8320
Phone (920) 490-9046

Other names 1

  • Carrie Iskra Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250721002980 WI Practitioner - Physician Assistant 9638221393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Clinic LLPGroup PAC ID 4385554328, 197 clinicians

Practice addresses (Care Compare)

1160 Kepler Dr
Green Bay, WI 54311-8321
Phone (920) 288-5555

2845 Greenbrier Rd
Green Bay, WI 54311-6519

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Clinic LLP CurrentSince Jan 1, 2026 Accepting new patients
Baycare Clinic LLP CurrentSince Jan 1, 2026 Accepting new patients
Bell Medical Center PastSince Apr 30, 2013 Accepting new patients

Locations

1110 Kepler Dr
Green Bay, WI 54311
Phone (920) 288-4712

2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400

1035 Kepler Dr
Green Bay, WI 54311

1500 Arbor Way
Kaukauna, WI 54130
Phone (877) 229-2273

3003 University Dr
Marinette, WI 54143
Phone (715) 735-4200

719 Doctors Ct
Oshkosh, WI 54901
Phone (920) 235-0066

1910 Alabama St
Sturgeon Bay, WI 54235
Phone (920) 746-7200

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1558500116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 KEPLER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118320",
            "telephone_number": "920-490-9046",
            "fax_number": "920-405-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 KEPLER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118306",
            "telephone_number": "920-288-5555",
            "fax_number": "920-288-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIGAN",
        "first_name": "CARRIE",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-05",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4265-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "ISKRA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.