NPIMap

Organization Active NPI

Bellin Memorial Hospital Inc

Doing business as FMC Oconto Falls

  • Rural Health Clinic/Center
  • Oconto Falls, WI
National Provider Identifier
1285696963
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BELLIN MEMORIAL HOSPITAL INC
Doing business as
FMC Oconto Falls
Practice address
107 E Highland Dr
Oconto Falls, WI 54154-1002
Phone
(920) 846-3092
Fax
(920) 846-8313
NPI assigned
Apr 6, 2006
Last updated
Oct 16, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
BELLIN MEMORIAL HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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) 445-7226

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

107 E Highland Dr
Oconto Falls, WI 54154-1002

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
43059400MedicaidWI

Other names 1

  • FMC OCONTO FALLS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

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

National Provider Directory

National Provider Directory
Part of
Womens Spec CR Marinett

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Oct 1, 2020 Acquisition/MergerThis provider was the seller Emplify Health Oconto Falls ClinicCCN 528617, WI, NPI 1063038313

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1285696963",
    "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": "107 E HIGHLAND DR",
            "city": "OCONTO FALLS",
            "state": "WI",
            "postal_code": "541541002",
            "telephone_number": "920-846-3092",
            "fax_number": "920-846-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLIN MEMORIAL HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BELLIN MEMORIAL HOSPITAL INC",
        "enumeration_date": "2006-04-06",
        "last_updated": "2019-10-16",
        "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": "920-445-7226"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43059400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FMC OCONTO FALLS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FMC OCONTO FALLS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oconto Falls, WI

Sources for this page

Verify at the official NPI Registry.