NPIMap

Organization Active NPI

Bellin Medical Group

  • Non-Pharmacy Dispensing Site
  • Oconto Falls, WI
National Provider Identifier
1871677419
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
24066020 Issued in WI
Legal business name
BELLIN MEDICAL GROUP
Doing business as
Bellin Medical Group
Practice address
833 S Main St
Oconto Falls, WI 54154-1241
Phone
(920) 846-3092
Fax
(920) 846-8313
NPI assigned
Oct 24, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Direndia Shackelford
Title
Managed Care Specialist
Phone
(800) 654-0889

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 24066020 WI Primary

Addresses

Primary practice location

833 S Main St
Oconto Falls, WI 54154-1241

Mailing address

PO Box 985
Oconto Falls, WI 54154-0985

Other identifiers 2

IdentifierTypeStateIssuer
30611600MedicaidWI
5125427OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • BELLIN MEDICAL GROUP Doing business as

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871677419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 985",
            "city": "OCONTO FALLS",
            "state": "WI",
            "postal_code": "541540985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 S MAIN ST",
            "city": "OCONTO FALLS",
            "state": "WI",
            "postal_code": "541541241",
            "telephone_number": "920-846-3092",
            "fax_number": "920-846-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLIN MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHACKELFORD",
        "authorized_official_first_name": "DIRENDIA",
        "authorized_official_title_or_position": "MANAGED CARE SPECIALIST",
        "authorized_official_telephone_number": "800-654-0889"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "WI",
            "license": "24066020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30611600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "5125427",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BELLIN MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oconto Falls, WI

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.