Collin Ellott Bowman, M.D.
Individual provider Active NPI Hospice and Palliative Medicine (Family Medicine) Physician · Green Bay, WI
NPI 1922462092 · NPPES record last updated Aug 23, 2023
Key facts
- NPI
- 1922462092
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X
- License
- 81538-20 (WI)
- Practice address
- 1580 Commanche Ave
Green Bay, WI 54313-5751 - Phone
- (920) 435-8326
- Fax
- (920) 430-4659
- NPI assigned
- Apr 5, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 24
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Hospice/Palliative Care
- Education
- Indiana University School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Bellin Memorial Hospital Inc
Oconto Hospital and Medical Center Inc
Practice addresses (Care Compare)
1580 Commanche Ave
Green Bay, WI 54313-5751
Phone (920) 435-8326
2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225
Hospital & facility affiliations
- Bellin Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230829001269 | WI | Practitioner - Hospice/Palliative Care |
3375826035 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 81538-20 | WI | MD | Hospice and Palliative Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oconto Hospital & Medical Center Inc | Hospice and Palliative Medicine | Current |
Accepting new patients |
| Oconto Hospital & Medical Center Inc | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Hospice and Palliative Medicine | Current | Accepting new patients |
| Bellin Memorial Hospital Inc | Current |
Accepting new patients | |
| Oconto Hospital & Medical Center Inc | Hospice and Palliative Medicine | Current |
Accepting new patients |
| Bellin Memorial Hospital Inc | Current |
Accepting new patients | |
| Bellin Memorial Hospital Inc | Past | Accepting new patients |
Locations
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
1580 Commanche Ave
Green Bay, WI 54313
Phone (920) 431-5687
2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171
820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100
Interoperability endpoints
- cbowman935737@direct.emplifyhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Family Medicine) Physician | 207QH0002X | 81538-20 | WI | Yes |
Addresses
Primary practice location
1580 Commanche Ave
Green Bay, WI 54313-5751
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210
Other practice location 1
7979 N Shadeland Ave Ste 300
Indianapolis, IN 46250-2042
Phone (317) 621-4418
Other practice location 2
10122 E 10th St
Suite 100
Indianapolis, IN 46229-2663
Phone (317) 355-5717
Other practice location 3
2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225
Other practice location 4
820 Arbutus Ave
Oconto, WI 54153-2004
Phone (920) 835-1100
Other providers in Green Bay, WI
- Jamey Michael Boucher
- Thomas Boucher
- Lynn Boughton
- Emily R Bourguignon
- Sally Beth Bowa
- Daniel Bowman
- Jared E Boyd
- Thomas C Boyd
- Sarah Ann Boyea
- Marta Robin Brace
All providers in Green Bay, WI · Hospice and Palliative Medicine (Family Medicine) Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.