NPIMap

Organization Active NPI

Bellin Memorial Hospital Inc

Doing business as Bellin Health Heart and Vascular Manitowoc

  • Cardiovascular Disease Physician
  • Manitowoc, WI
National Provider Identifier
1710130216
Registry record updated Dec 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
BELLIN MEMORIAL HOSPITAL INC
Doing business as
Bellin Health Heart and Vascular Manitowoc
Practice address
208 East Reed Street
Suite B
Manitowoc, WI 54220-2121
Phone
(920) 264-2920
NPI assigned
Oct 28, 2008
Last updated
Dec 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2008

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

Authorized official

Name
Denise K Stroobants
Title
Clinic Credentialing
Phone
(920) 445-7222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

208 East Reed Street
Suite B
Manitowoc, WI 54220-2121

Mailing address

208 East Reed Street
Suite B
Manitowoc, WI 54220-2121
Phone (920) 264-2920

Other identifiers 1

IdentifierTypeStateIssuer
1710130216MedicaidWI

Other names 1

  • BELLIN HEALTH HEART AND VASCULAR MANITOWOC 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
Bellin Memorial Hospita55 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

1800 Lawrence Dr
De Pere, WI 54115
Phone (920) 983-3220

208 E Reed Ave
Ste B
Manitowoc, WI 54220
Phone (920) 264-2920

Practitioners & affiliated clinicians

Practitioners 9

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": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230595200000",
    "number": "1710130216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 EAST REED STREET",
            "address_2": "SUITE B",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542202121",
            "telephone_number": "920-264-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 EAST REED STREET",
            "address_2": "SUITE B",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542202121",
            "telephone_number": "920-264-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLIN MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-12-30",
        "status": "A",
        "authorized_official_last_name": "STROOBANTS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CLINIC CREDENTIALING",
        "authorized_official_telephone_number": "920-445-7222"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710130216",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BELLIN HEALTH HEART AND VASCULAR MANITOWOC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2008; 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.