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Bellin Memorial Hospital Inc

Organization Active NPI Mobile Radiology Clinic/Center · Green Bay, WI

NPI 1740600600 · NPPES record last updated Oct 18, 2021

Key facts

NPI
1740600600
Entity type
Organization (NPI type 2)
Primary specialty
Mobile Radiology Clinic/Center 261QR0208X
Legal business name
BELLIN MEMORIAL HOSPITAL INC
Practice address
744 S Webster Ave
Green Bay, WI 54301-3505
Phone
(920) 445-7222
NPI assigned
Apr 18, 2014
Organization subpart
No

Authorized official

Name
Denise K Stroobants
Title
Credentialing Specialist
Phone
(920) 433-7864

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).

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 687

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

View all 687

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI

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
O20150820010491 WI Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8820900749 Practice locations: Green Bay, WI

National Provider Directory

Tax ID family
Daggett Medical Clinic (54 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mobile Mammography Clinic/Center 261QR0207X WI
Mobile Radiology Clinic/Center 261QR0208X WI Yes

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) 445-7222

Other identifiers

IdentifierTypeStateIssuer
102970OtherWIACR CERTIFICATION

Other names

  • MOBILE DIAGNOSTIC IDTF Doing business as

Other providers in Green Bay, WI

All providers in Green Bay, WI · Mobile Radiology Clinic/Center in Wisconsin

Sources for this page

Verify at the official NPI Registry.