Bellin Memorial Hospital Inc

Organization Active NPI Rural Health Clinic/Center · Algoma, WI

NPI 1609838473 · NPPES record last updated Jul 28, 2025

Key facts

NPI
1609838473
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
BELLIN MEMORIAL HOSPITAL INC
Practice address
831 Parker St
Algoma, WI 54201-1948
Phone
(920) 487-3676
NPI assigned
Apr 5, 2006
Organization subpart
Yes
Parent organization (as reported)
BELLIN MEMORIAL HOSPITAL INC

Authorized official

Name
Abby Julia Engebose
Title
Credentialing Specialist
Phone
(920) 433-7860

Owners & managing parties with NPI records 2

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

Owned or controlled facilities with NPI records 12

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

Other NPIs with the same Medicare PAC ID 9

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

Facilities with the same owner 50

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

View all 50

Practitioners 1,012

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 1,012

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in WI

Rural health clinic certification: CCN 523865

Legal name
BELLIN MEMORIAL HOSPITAL INC
Doing business as
FMC ALGOMA
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 1, 2001
Last certification
Sep 16, 2019
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Incorporated
Nov 28, 1908 in WI
Enrollment address
831 Parker Ave
Algoma, WI 54201-1808

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 Oct 1, 2022
Debra Van Pay
Individual
Corporate Director Dec 1, 2025
W-2 Managing Employee
Director
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 100%
Bellin Health Systems, Inc.
Organization · Green Bay, WI
Corporation
5% Or Greater Direct Ownership Interest Oct 1, 2022 100%
Laura a Hieb
Individual
Corporate Director Oct 1, 2022
Peter Vandenhouten
Individual
Corporate Director Oct 1, 2022

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 Clinic
Oconto, WI · CCN 521356
Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2021
Emplify Health Oconto Hospital
Oconto, WI · CCN 52Z356
Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2021
Unity
De 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 Clinic
Oconto, WI · CCN 528554
Rural health clinic 5% Or Greater Indirect Ownership Interest Jun 1, 2021
Emplify Health Peshtigo Clinic
Peshtigo, WI · CCN 528580
Rural health clinic 5% Or Greater Indirect Ownership Interest Nov 14, 2016
Emplify Health Crivitz Clinic
Crivitz, WI · CCN 528579
Rural health clinic 5% Or Greater Indirect Ownership Interest Nov 14, 2016
Emplify Health Menominee Clinic
Menominee, MI · CCN 238705
Rural health clinic 5% Or Greater Indirect Ownership Interest Nov 14, 2016
Emplify Health Daggett Clinic
Daggett, MI · CCN 238704
Rural health clinic 5% Or Greater Indirect Ownership Interest Nov 14, 2016
Emplify Health Marinette Clinic
Marinette, WI · CCN 528578
Rural health clinic 5% Or Greater Indirect Ownership Interest Oct 14, 2016
Emplify Health Oconto Falls Clinic
Oconto Falls, WI · CCN 528617
Rural health clinic 5% Or Greater Indirect Ownership Interest Oct 1, 2020
Emplify Health Lakewood Clinic
Lakewood, WI · CCN 528630
Rural health clinic 5% Or Greater Indirect Ownership Interest Jan 1, 2022
Emplify Health Suring Clinic
Suring, WI · CCN 528631
Rural health clinic 5% Or Greater Indirect Ownership Interest Jan 19, 2022

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031121000089 WI Part B Supplier - Clinic/Group Practice 8820900749 Receives reassigned benefits from 936 practitioners
O20050909000145 WI Part a Provider - Rural Health Clinic 8820900749 Practice locations: Algoma, WI

National Provider Directory

Part of
Daggett Medical Clinic

Locations

595 R Rd
Denmark, WI 54208
Phone (920) 863-2005

Specialties & licenses

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

Addresses

Primary practice location

831 Parker St
Algoma, WI 54201-1948

Mailing address

831 Parker St
Algoma, WI 54201-1948
Phone (920) 487-3676

Other identifiers

IdentifierTypeStateIssuer
43057500MedicaidWI

Other names

  • Bellin Health Algoma Doing business as
  • FMC ALGOMA Doing business as

Other providers in Algoma, WI

All providers in Algoma, WI · Rural Health Clinic/Center in Wisconsin

Sources for this page

Verify at the official NPI Registry.