Collin Ross Backowski

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

26297 139TH Ave
Fort Ripley, MN 56449-2060

Phone

(320) 630-7967

NPI assigned

Feb 12, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1700640695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26297 139TH AVE",
            "city": "FORT RIPLEY",
            "state": "MN",
            "postal_code": "564492060",
            "telephone_number": "320-630-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26297 139TH AVE",
            "city": "FORT RIPLEY",
            "state": "MN",
            "postal_code": "564492060",
            "telephone_number": "320-630-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKOWSKI",
        "first_name": "COLLIN",
        "middle_name": "ROSS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dean Ray Schmiedt, PHARM.D.
• Sarah Stout
• Renae Suzanne Stueber, MS, CCC
• Francine H. Trtanj, MSW, LICSW

• Social Worker in Fort Ripley, MN
• Providers in Fort Ripley, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.