Bellin Memorial Hospital Inc
Organization Active NPI Pediatrics Physician · De Pere, WI
NPI 1235192592 · NPPES record last updated Oct 18, 2021
Key facts
- NPI
- 1235192592
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- Legal business name
- BELLIN MEMORIAL HOSPITAL INC
- Practice address
- 555 Redbird Cir
De Pere, WI 54115-7977 - Phone
- (920) 338-6820
- NPI assigned
- Apr 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Denise K Stroobants
- Title
- Credentialing Specialist
- Phone
- (920) 433-7864
Corporate family (same tax ID) 24
Practitioners 10
-
Allison Lynn Blatz, NNP-BC
-
Brooke A Ferguson, DPT
-
Sherri L Hoyman, DO
-
Mark R Kroll, D.O.
-
Kelly A Mathes, D.O.
-
Penelope McGee, MS, LPC
-
Laura B Pethan, APNP
-
Ryan Robert Thyssen, PT, DPT
-
Julie Johnson Roberts, M.D.
-
George X Zaleski, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031121000089 | WI | Part B Supplier - Clinic/Group Practice | 8820900749 |
Receives reassigned benefits from 936 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Daggett Medical Clinic
Locations
555 Redbird Cir
Ste 200
De Pere, WI 54115
Phone (920) 338-6820
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | Yes |
Addresses
Primary practice location
555 Redbird Cir
De Pere, WI 54115-7977
Mailing address
555 Redbird Cir
Suite 200
De Pere, WI 54115-7977
Phone (920) 338-6820
Other names
- FMC PEDIATRICS EAST
Other providers in De Pere, WI
- Edward D Bayer
- Bayside Chiropractic LLC
- Beautifully Broken Counseling LLC
- Christopher George Bechakas
- Bellin Memorial Hospital Inc
- Bellin Memorial Hospital Inc
- Bellin Psychiatric Center Inc
- Bellin Psychiatric Center Inc
- Bellin Psychiatric Center Inc
- Lauren Madison Bellin
All providers in De Pere, WI · Pediatrics Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.