BELLIN MEMORIAL HOSPITAL INC (NPI# 1073566725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073566725 |
| Entity Type | Organization |
| Organization Name | BELLIN MEMORIAL HOSPITAL INC |
| Other Organization Name | FMC BELLIN HEALTH FAST CARE ASHWAUBENON |
| Practice Address |
2015 Shawano Ave Green Bay WI 54303-2606 |
| Mailing Address |
Po Box 22487 Green Bay WI 54305-2487 |
| Practice Telephone | 9205929478 |
| Practice Fax Number | 9205929479 |
| Mailing Telephone | 9204457222 |
| Mailing Fax Number | 9204457289 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2019-05-31 |
| Authorized Official Name | DENISE K STROOBANTS (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 9204457226 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 21300300 | 05 |
| Other Name | Type Code |
|---|---|
| Bellin Health Fast Care West | Doing Business As Name - Organization |
| FMC BELLIN HEALTH FAST CARE ASHWAUBENON | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114563707 | Bellin Memorial Hospital Inc | Clinic/Center | 1241 Lombardi Access Rd Ste H, Green Bay, WI 54304-4059 | 2019-11-19 |
| 1003202631 | Bellin Memorial Hospital Inc | Orthopaedic Surgery | 218 So Hwy 141, Crivitz, WI 54114-1636 | 2015-04-10 |
| 1174890024 | Bellin Memorial Hospital Inc | Nurse Practitioner | 229 N 14th Ave, Sturgeon Bay, WI 54235-1317 | 2011-11-21 |
| 1003107723 | Bellin Memorial Hospital Inc | Clinic/Center | 3100 Ams Blvd, Ste C, Green Bay, WI 54313-9700 | 2011-04-28 |
| 1710130216 | Bellin Memorial Hospital Inc | Internal Medicine | 208 East Reed Street, Suite B, Manitowoc, WI 54220-2121 | 2008-10-28 |
| 1699926964 | Bellin Memorial Hospital Inc | Internal Medicine | 820 Arbutus Ave Ste P, Oconto, WI 54153-2004 | 2008-10-06 |
| 1104022128 | Bellin Memorial Hospital Inc | Family Medicine | 704 S Webster Ave Ste 201, Green Bay, WI 54301-3528 | 2007-06-26 |
| 1376649509 | Bellin Memorial Hospital Inc | Internal Medicine | 1328 Us Hwy 2, Crystal Falls, MI 49920 | 2006-09-15 |
| 1346293941 | Bellin Memorial Hospital Inc | Family Medicine | 1976 Lime Kiln Rd, Green Bay, WI 54311-4417 | 2006-05-18 |
| 1225091580 | Bellin Memorial Hospital Inc | Family Medicine | 555 Quality Court, Wrightstown, WI 54180 | 2006-04-08 |
| Street Address |
2015 SHAWANO AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-2606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306341201 | Jordan Doberstein | Pharmacist | 2015 Shawano Ave, Green Bay, WI 54303-2606 | 2018-03-24 |
| 1215472089 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 2015 Shawano Ave, Green Bay, WI 54303-2606 | 2017-01-03 |
| 1508257288 | Jason Wettengel | Pharmacist | 2015 Shawano Ave, Green Bay, WI 54303-2606 | 2015-02-16 |
| 1780964403 | Adam N Lubin | Pharmacist | 2015 Shawano Ave, Green Bay, WI 54303-2606 | 2011-08-25 |
| 1407033111 | Bellin Memorial Hospital Inc | Family Medicine | 2015 Shawano Ave, Green Bay, WI 54303-2606 | 2008-01-24 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528259397 | Venkata Ravi Kiran Kadipi Reddy | Family Medicine | 2793 Lineville Road, Green Bay, WI 54307 | 2007-08-07 |
| 1104022128 | Bellin Memorial Hospital Inc | Family Medicine | 704 S Webster Ave Ste 201, Green Bay, WI 54301-3528 | 2007-06-26 |
| 1942336839 | Richard Gordon Heidorn | Family Medicine | 2833 Riverside Dr, Green Bay, WI 54301-1635 | 2007-02-26 |
| 1720137656 | Daniel G Koster Md Sc | Family Medicine | 744 S Webster Ave Fl 5, Green Bay, WI 54301-3505 | 2007-01-09 |
| 1356424691 | Marjorie J Delo | Family Medicine | 2595 Development Dr Ste 140, Green Bay, WI 54311-4267 | 2006-10-23 |
| 1700894433 | Suzanne H Barnes | Family Medicine | 1565 Allouez Ave, Green Bay, WI 54311 | 2006-08-05 |
| 1407871684 | John Tracy Warren | Family Medicine | 1685 Macarthur St, Green Bay, WI 54301-2454 | 2006-07-12 |
| 1255364642 | Gail S Carels | Family Medicine | 2502 S. Ashland Ave, Green Bay, WI 54304 | 2006-07-08 |
| 1346293941 | Bellin Memorial Hospital Inc | Family Medicine | 1976 Lime Kiln Rd, Green Bay, WI 54311-4417 | 2006-05-18 |
| 1780647040 | Bellin Memorial Hospital Inc | Family Medicine | 704 S Webster Ave Ste 200, Green Bay, WI 54301-3531 | 2006-04-08 |
| Find all providers in GREEN BAY | ||||
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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.