DR. MATTHEW BRENDON COLLIGAN (NPI# 1174528202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174528202 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW BRENDON COLLIGAN |
| Credential | D.O. |
| Practice Address |
1715 Dousman St Green Bay WI 54303-3211 |
| Practice Telephone | 9204964700 |
| Mailing Telephone | 9204964700 |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2015-03-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | OS9282 | FL | Allopathic & Osteopathic Physicians |
| Y | 207X00000X | Orthopaedic Surgery | 63648-21 | WI | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 5101014350 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4820631 | 05 | |
| FL | 270390400 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083017107 | Matthew Ryan Colligan I | Behavioral Analyst | 1456 York St, Mahwah, NJ 07430-3263 | 2014-10-02 |
| Street Address |
1715 DOUSMAN ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-3211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629071485 | Gayle M Kasdorf | Internal Medicine | 1715 Dousman St, Green Bay, WI 54303-3211 | 2005-05-24 |
| 1508476771 | Alea Meyer | Audiologist | 1715 Dousman St, Green Bay, WI 54303-3211 | 2020-08-03 |
| 1003476276 | Jenna Mae Hanson | Physician Assistant | 1715 Dousman St, Green Bay, WI 54303-3211 | 2019-06-19 |
| 1932672409 | Kaylee Elizabeth Hoppe | Physician Assistant | 1715 Dousman St, Green Bay, WI 54303-3211 | 2019-01-08 |
| 1205307170 | Marjorie Hatszegi | Nurse Practitioner | 1715 Dousman St, Green Bay, WI 54303-3211 | 2018-12-17 |
| 1700362860 | Cassandra Jean Bedore | Audiologist | 1715 Dousman St, Green Bay, WI 54303-3211 | 2018-07-12 |
| 1033632336 | Shilpa Mohan Ullikashi | Pediatrics | 1715 Dousman St, Green Bay, WI 54303-3211 | 2017-07-19 |
| 1811431372 | Lauryn Carlson | Registered Nurse | 1715 Dousman St, Green Bay, WI 54303-3211 | 2016-12-16 |
| 1831543529 | Rachael John | Occupational Therapist | 1715 Dousman St, Green Bay, WI 54303-3211 | 2016-04-19 |
| 1780099911 | Anusha Surender | Internal Medicine | 1715 Dousman St, Green Bay, WI 54303-3211 | 2014-06-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689847790 | Joel Evan Hein | Orthopaedic Surgery | 2223 Lime Kiln Rd Ste 1, Green Bay, WI 54311-6213 | 2008-04-09 |
| 1326021288 | Robert Bentley Anderson | Orthopaedic Surgery | 1970 S Ridge Rd, Green Bay, WI 54304-4125 | 2005-11-23 |
| 1245224021 | Daniel P Metz | Orthopaedic Surgery | 2502 S. Ashland Ave., Green Bay, WI 54304 | 2005-09-07 |
| 1144883299 | Baycare Clinic, LLP | Orthopaedic Surgery | 4070 Equestrian Ln, Green Bay, WI 54229-9649 | 2019-04-15 |
| 1114398849 | Bellin Memorial Hospital Inc | Orthopaedic Surgery | 1630 Commanche Ave, Green Bay, WI 54313-5753 | 2015-10-07 |
| 1467867754 | Kevin H Shepet | Orthopaedic Surgery | 1970 S Ridge Rd, Green Bay, WI 54304-4125 | 2014-06-25 |
| 1649615329 | John Tokunbo Awowale | Orthopaedic Surgery | 1160 Kepler Dr, Green Bay, WI 54311 | 2013-05-07 |
| 1033451588 | William Victor Albiero | Orthopaedic Surgery | 2223 Lime Kiln Rd Ste 1, Green Bay, WI 54311 | 2013-03-22 |
| 1669736609 | Andrew John Kirkpatrick | Orthopaedic Surgery | 1160 Kepler Dr, Green Bay, WI 54311 | 2012-06-25 |
| 1134494339 | Michael Jameson Florack | Orthopaedic Surgery | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2012-03-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.