Beloit Clinic, S.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BELOIT CLINIC, S.C.

Practice address

1701 Blackhawk Blvd
South Beloit, IL 61080-2407

Phone

(608) 364-1348

Fax

(608) 364-2338

NPI assigned

Mar 19, 2007

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

Ruth Gray

Title

Assistant Administrator

Phone

(608) 364-1348

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• South Beloit Clinic Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346364718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 E HUEBBE PKWY",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-1348",
            "fax_number": "608-364-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 BLACKHAWK BLVD",
            "city": "SOUTH BELOIT",
            "state": "IL",
            "postal_code": "610802407",
            "telephone_number": "608-364-1348",
            "fax_number": "608-364-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELOIT CLINIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "608-364-1348"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32069700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Beloit Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer Marie Auge, CSFA
• Beloit Health System, Inc (South Beloit Clinic - BHS)
• Board of Trustees of the University of Illinois (University Clinic at South Beloit School District)
• Diane Marie Brandlein, DDS
• Barbara Ann Bressler, DT
• Daniel Bressler, MT-BC

• Family Medicine Physician in South Beloit, IL
• Providers in South Beloit, IL by specialty
• Family Medicine Physician in Illinois

• 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.