Brown County Health Care Center Bayview Develpmental Center

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

2986 Issued in WI

Legal business name

BROWN COUNTY HEALTH CARE CENTER BAYVIEW DEVELPMENTAL CENTER

Practice address

2900 Saint Anthony Dr
Green Bay, WI 54311-5859

Phone

(920) 391-4700

Fax

(920) 391-4870

NPI assigned

Sep 13, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Diane Pivonka, RN, MS, APNP, NHA

Title

Inpatient Services Director

Phone

(920) 391-4700

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144325267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 SAINT ANTHONY DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115859",
            "telephone_number": "920-391-4700",
            "fax_number": "920-391-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 SAINT ANTHONY DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115859",
            "telephone_number": "920-391-4700",
            "fax_number": "920-391-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWN COUNTY HEALTH CARE CENTER BAYVIEW DEVELPMENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PIVONKA",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "INPATIENT SERVICES DIRECTOR",
        "authorized_official_telephone_number": "920-391-4700",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, MS, APNP, NHA"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "WI",
            "license": "2986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21050800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Brooks, MD
• David J. Brooks, M.D.
• Katelyn Marie Brosig
• Michael A. Brossman, DMD
• Brown County
• Brown County Health Department
• Brown County Oral Health Partnership, Inc.
• Samantha K Brown-Nooyen, LMT
• Cynthia J Brown-Sullivan, MD
• Ashley Brown, MS CCC-SLP

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.