Bellin Memorial Hospital Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BELLIN MEMORIAL HOSPITAL INC

Practice address

235 E Ryan St
Brillion, WI 54110-1132

Phone

(920) 756-2055

Fax

(920) 756-3350

NPI assigned

Apr 5, 2006

Organization subpart

Yes

Parent organization

BELLIN MEMORIAL HOSPITAL INCAs reported in NPPES

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

Authorized official

Name

Abby Julia Engebose

Title

Credentialing Specialist

Phone

(920) 433-7860

Specialties & licenses 1

Addresses

Other names 1

• FMC BRILLION Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Part of

Daggett Medical Clinic

Locations (25 of 26)

Practitioners 460

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

• Kyla S Balzar, NP

  • Family Nurse Practitioner
  • Green Bay, WI
  • NPI 1487316006
  NPD
• Marcus A Boehm, DPT

  • Physical Therapist
  • Green Bay, WI
  • NPI 1356869416
  NPD
• Jessica L Burkett, D-PT

  • Physical Therapist
  • Green Bay, WI
  • NPI 1770011256
  NPD
• Kristin M Collar, APNP

  • Family Nurse Practitioner
  • Seymour, WI
  • NPI 1265711311
  NPD
• Ashley Lucille Dudka, OTR

  • Occupational Therapist
  • De Pere, WI
  • NPI 1346981453
  NPD
• Benjamin L Erickson, A.A.

  • Anesthesiologist Assistant
  • Milwaukee, WI
  • NPI 1639715428
  NPD
• Nana Sarkoah Ivy Fenny, M.D.

  • Allergy & Immunology (Internal Medicine) Physician
  • Green Bay, WI
  • NPI 1689998262
  NPD
• Alyssa M Harris, LPC

  • Addiction (Substance Use Disorder) Counselor
  • Green Bay, WI
  • NPI 1598063257
  NPD
• Andrew Russell Kost, CAA

  • Anesthesiologist Assistant
  • Green Bay, WI
  • NPI 1033861729
  NPD
• Michael R Mankovecky, DPM

  • Podiatrist
  • Green Bay, WI
  • NPI 1346532678
  NPD
• Kimberly M Maxson, APNP

  • Family Nurse Practitioner
  • Green Bay, WI
  • NPI 1386288132
  NPD
• Jennifer L. Weier, APNP

  • Nurse Practitioner
  • Two Rivers, WI
  • NPI 1891198735
  NPD

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1962464784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E RYAN ST",
            "city": "BRILLION",
            "state": "WI",
            "postal_code": "541101132",
            "telephone_number": "920-756-2055",
            "fax_number": "920-756-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E RYAN ST",
            "city": "BRILLION",
            "state": "WI",
            "postal_code": "541101132",
            "telephone_number": "920-756-2055",
            "fax_number": "920-756-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLIN MEMORIAL HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BELLIN MEMORIAL HOSPITAL INC",
        "enumeration_date": "2006-04-05",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "ENGEBOSE",
        "authorized_official_first_name": "ABBY",
        "authorized_official_middle_name": "JULIA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "920-433-7860"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FMC BRILLION",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FMC BRILLION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bel-Regional Home Medical Inc
• Lindy Ruth Berglund, M.A.-SLP
• Richelle L. Bruette
• Vineta Caune-Meyer, LMT
• City of Brillion
• Community Eyecare Inc

• All providers in Brillion, WI
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.