NPIMap

Organization Active NPI

Bellin Memorial Hospital Inc

Doing business as Extended Hours

  • Family Medicine Physician
  • Green Bay, WI
National Provider Identifier
1669434338
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BELLIN MEMORIAL HOSPITAL INC
Doing business as
Extended Hours
Practice address
744 S Webster Ave
Green Bay, WI 54301-3505
Phone
(920) 445-7300
NPI assigned
Apr 6, 2006
Last updated
Oct 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Denise K Stroobants
Title
Provider/Clinic Maintenance
Phone
(920) 433-7864

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

744 S Webster Ave
Green Bay, WI 54301-3505

Mailing address

744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 445-7300

Other names 1

  • EXTENDED HOURS 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
Tax ID family
Womens Spec CR Marinett55 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

Locations

1325 Angels Path
De Pere, WI 54115
Phone (920) 338-2855

2020 Riverside Dr
Ste 200
Green Bay, WI 54301
Phone (920) 433-9920

Practitioners & affiliated clinicians

Practitioners 10

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.

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": "1634515200000",
    "number": "1669434338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-445-7300"
        },
        {
            "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": "920-445-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLIN MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "STROOBANTS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PROVIDER/CLINIC MAINTENANCE",
        "authorized_official_telephone_number": "920-433-7864"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EXTENDED HOURS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EXTENDED HOURS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.