NPIMap

Organization Active NPI

Bellin Memorial Hospital, Inc

  • Rehabilitation Hospital Unit
  • Green Bay, WI
National Provider Identifier
1174689178
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
147 Issued in WI
Legal business name
BELLIN MEMORIAL HOSPITAL, INC
Practice address
744 S Webster Ave
Green Bay, WI 54301-3505
Phone
(920) 433-3655
Fax
(920) 433-3539
NPI assigned
Dec 28, 2006
Last updated
Jan 26, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
BELLIN MEMORIAL HOSPITAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 26, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 147 WI Primary
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

744 S Webster Ave
Green Bay, WI 54301-3505

Mailing address

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

Other names 1

  • INPATIENT REHAB Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 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
O20060830000332 WI Part A Provider - Hospital 8820900749 Practice locations: Greenbay, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174689178. Details of each certification follow.

Hospital certification: CCN 52T049

Legal name
BELLIN MEMORIAL HOSPITAL INC
Doing business as
BELLIN MEMORIAL HOSPITAL REHABILITATION UNIT
Organization structure
CorporationNon-profit
Incorporated
Mar 20, 1989 in WI
Enrollment address
725S Webster Ave
Greenbay, WI 54301-3500
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Bellin Memorial HospitalCCN 52T049 · All quality measures
Ownership
Non-profit
Certified
Oct 1, 2011

National Provider Directory

National Provider Directory
Tax ID family
Bellin Memorial Hospita55 organizations share this tax ID, including this one
Part of
Bellin Memorial Hospita

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Michael Landrum Individual Corporate Director Dec 1, 2025
Scott Rathgaber Individual Corporate Director Dec 1, 2022
Debra Van Pay Individual Corporate DirectorDirector Dec 1, 2025
W-2 Managing EmployeeDirector Dec 1, 2025
Sharla Baenen Individual Corporate Director Oct 1, 2022
Sara L Arndt Individual W-2 Managing Employee Oct 1, 2022
Bellin Gundersen Health System Inc Organization, La Crosse, WI Corporation 5% Or Greater Indirect Ownership Interest Dec 1, 2022
Bellin Health Systems, Inc. Organization, Green Bay, WI Corporation 5% Or Greater Direct Ownership Interest Oct 1, 2022
Laura a Hieb Individual Corporate Director Oct 1, 2022
Peter Vandenhouten Individual Corporate Director Oct 1, 2022

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 12

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Emplify Health Oconto ClinicOconto, WI, CCN 521356 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2021
Emplify Health Oconto HospitalOconto, WI, CCN 52Z356 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2021
UnityDe Pere, WI, CCN 521503 Hospice 5% Or Greater Direct Ownership Interest (45%)
Limited Partnership Interest (45%)
Operational/Managerial Control (45%)		 Oct 1, 1992
Oct 1, 1992
Oct 1, 1992
Emplify Health Oconto ClinicOconto, WI, CCN 528554 Rural health clinic 5% Or Greater Indirect Ownership Interest Jun 1, 2021
Emplify Health Peshtigo ClinicPeshtigo, WI, CCN 528580 Rural health clinic 5% Or Greater Indirect Ownership Interest Nov 14, 2016
Emplify Health Crivitz ClinicCrivitz, WI, CCN 528579 Rural health clinic 5% Or Greater Indirect Ownership Interest Nov 14, 2016
Emplify Health Menominee ClinicMenominee, MI, CCN 238705 Rural health clinic 5% Or Greater Indirect Ownership Interest Nov 14, 2016
Emplify Health Daggett ClinicDaggett, MI, CCN 238704 Rural health clinic 5% Or Greater Indirect Ownership Interest Nov 14, 2016
Emplify Health Marinette ClinicMarinette, WI, CCN 528578 Rural health clinic 5% Or Greater Indirect Ownership Interest Oct 14, 2016
Emplify Health Oconto Falls ClinicOconto Falls, WI, CCN 528617 Rural health clinic 5% Or Greater Indirect Ownership Interest Oct 1, 2020
Emplify Health Lakewood ClinicLakewood, WI, CCN 528630 Rural health clinic 5% Or Greater Indirect Ownership Interest Jan 1, 2022
Emplify Health Suring ClinicSuring, WI, CCN 528631 Rural health clinic 5% Or Greater Indirect Ownership Interest Jan 19, 2022

Owned or controlled facilities with NPI records 12

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 50

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 50

Practitioners & affiliated clinicians

Practitioners 19

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 19

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611619200000",
    "number": "1174689178",
    "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": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-433-3655",
            "fax_number": "920-433-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLIN MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BELLIN MEMORIAL HOSPITAL, INC",
        "enumeration_date": "2006-12-28",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "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": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "WI",
            "license": "147",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INPATIENT REHAB",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "INPATIENT REHAB",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.