NPIMap

Organization Active NPI

Bellin Memorial Hospital Inc

Doing business as Bellin Health Sports Medicine and Orthopedics

  • Orthopaedic Surgery Physician
  • Green Bay, WI
National Provider Identifier
1114398849
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
BELLIN MEMORIAL HOSPITAL INC
Doing business as
Bellin Health Sports Medicine and Orthopedics
Practice address
1630 Commanche Ave
Green Bay, WI 54313-5753
Phone
(920) 593-5555
Fax
(920) 593-5549
NPI assigned
Oct 7, 2015
Last updated
Oct 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Authorized official

Name
Denise K Stroobants
Title
Credentialing Specialist
Phone
(920) 433-7864

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X WI Primary

Addresses

Primary practice location

1630 Commanche Ave
Green Bay, WI 54313-5753

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222

Other practice location 1

704 S Webster Ave
Green Bay, WI 54301-3528
Phone (920) 430-4888

Other practice location 2

1970 S Ridge Rd
Green Bay, WI 54304-4125
Phone (920) 430-4888

Other practice location 3

440 Woodward Ave
Iron Mountain, MI 49801-4631
Phone (906) 776-9040

Other practice location 4

3263 Eaton Rd
Green Bay, WI 54311-6830
Phone (920) 430-4888

Other practice location 5

2714 Riverview Dr
Green Bay, WI 54313-6715
Phone (920) 430-4760

Other names 1

  • Bellin Health Sports Medicine and Orthopedics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031121000089 WI Part B Supplier - Clinic/Group Practice 8820900749 Receives reassigned benefits from 936 practitioners
This NPI is an additional NPI on the enrollment
O20061218000510 MI Part B Supplier - Clinic/Group Practice 8820900749 Receives reassigned benefits from 183 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Iron Mountain, MI; Marquette, MI; Escanaba, MI

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1114398849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 COMMANCHE AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543135753",
            "telephone_number": "920-593-5555",
            "fax_number": "920-593-5549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "704 S Webster Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013528",
            "country_code": "US",
            "telephone_number": "920-430-4888",
            "fax_number": "920-430-4889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1970 S Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543044125",
            "country_code": "US",
            "telephone_number": "920-430-4888",
            "fax_number": "920-430-4889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "440 Woodward Ave",
            "address_purpose": "LOCATION",
            "city": "Iron Mountain",
            "state": "MI",
            "postal_code": "498014631",
            "country_code": "US",
            "telephone_number": "906-776-9040",
            "fax_number": "906-774-7279",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3263 Eaton Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543116830",
            "country_code": "US",
            "telephone_number": "920-430-4888",
            "fax_number": "920-430-4889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2714 Riverview Dr",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543136715",
            "country_code": "US",
            "telephone_number": "920-430-4760",
            "fax_number": "920-430-4774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BELLIN MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "STROOBANTS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "920-433-7864"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bellin Health Sports Medicine and Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bellin Health Sports Medicine and Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.