Philip J Colletier, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

27802 Issued in IA

Practice address

411 Laurel St
Suite C100
Des Moines, IA 50314-3017

Phone

(515) 643-5168

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Boone County Hospital

  • Critical Access Hospital
  • Boone, IA
  • NPI 1467434225
  NPD (past)
• Mercy Therapeutic Radiology Associates LLC

  • Radiation Oncology Physician
  • Des Moines, IA
  • NPI 1467511857
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760569412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 6TH AVE",
            "address_2": "SUITE 200",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142607",
            "telephone_number": "515-643-8672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 LAUREL ST",
            "address_2": "SUITE C100",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143017",
            "telephone_number": "515-643-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETIER",
        "first_name": "PHILIP",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IA",
            "license": "27802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK OF IOWA",
            "identifier": "40915",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1167379",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Erin Dachenbach Cohen, LMSW
• Katherine Cole, CADC
• Tammy Kay Colegrove, ARNP
• Kari Kristen Coleman, CPNP
• Taylor Faye Coleman, MSN, ARNP, FNP-C
• Amanda Collicott I, ARNP
• Darla Kay Collier, RN
• David C Collier, D.D.S.
• Collin E. Pehde DPM, PLLC
• Amanda Leigh Collins Messman, PH.D.

• Radiation Oncology Physician in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Radiation Oncology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.